TY 2015 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) CHRISTOPHER G DAWES...................................................................... PRESIDENT/CEO	50.0 ................. 2.0	X	X	1,607,856	0	473,513
(3) MARIANN BYERWALTER...................................................................... VICE CHAIR	3.0 ................. 2.0	X	X	0	0	0
(4) DAVID ALEXANDER MD...................................................................... DIRECTOR	3.0 ................. 0.0	X		0	0	0
(5) THOMAS KRUMMEL MD...................................................................... DIRECTOR	3.0 ................. 51.0	X		0	1,106,252	46,074
(6) CHRISTY SANDBORG MD...................................................................... DIRECTOR	3.0 ................. 51.0	X		0	424,439	50,546
(7) DANA G MEAD JR...................................................................... DIRECTOR (UNTIL 12/31/15)	3.0 ................. 0.0	X		0	0	0
(8) MARY B CRANSTON...................................................................... CHAIR	3.5 ................. 2.0	X	X	0	0	0
(9) HARRY R HAGEY...................................................................... DIRECTOR	3.0 ................. 0.0	X		0	0	0
(10) HUGH O'BRODOVICH MD...................................................................... DIRECTOR (UNTIL 06/30/16)	3.0 ................. 51.0	X		0	748,998	47,515
(11) SUSAN ORR...................................................................... VICE CHAIR	3.0 ................. 0.0	X	X	0	0	0
(12) ANNE BASS...................................................................... DIRECTOR (UNTIL 12/31/15)	3.0 ................. 0.0	X		0	0	0
(13) JEFFREY CHAMBERS...................................................................... VICE CHAIR	3.0 ................. 0.0	X	X	0	0	0
(14) JONATHAN COSLET...................................................................... DIRECTOR	3.0 ................. 0.0	X		0	0	0
(15) WILLIAM CROWN...................................................................... DIRECTOR	3.0 ................. 0.0	X		0	0	0
(16) SUSAN FORD DORSEY...................................................................... DIRECTOR	3.0 ................. 0.0	X		0	0	0
(17) ANN LIVERMORE...................................................................... 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) AMIR DAN RUBIN........................................................................ DIRECTOR (UNTIL 01/03/16)	3.0 .......................52.5	X					0	3,329,157	369,750
(19) J TAYLOR CRANDALL........................................................................ DIRECTOR (UNTIL 12/31/15)	3.0 .......................0.0	X					0	0	0
(20) JANE SHAW........................................................................ DIRECTOR	3.0 .......................0.0	X					0	0	0
(21) VAUGHN WILLIAMS........................................................................ DIRECTOR	3.0 .......................2.0	X					0	0	0
(22) JAMES WOODY MD........................................................................ DIRECTOR	3.0 .......................0.0	X					0	0	0
(23) LLOYD B MINOR MD........................................................................ DIRECTOR	3.0 .......................54.0	X					0	1,716,675	346,555
(24) ELAINE CHAMBERS........................................................................ DIRECTOR	3.5 .......................0.0	X					0	0	0
(25) JOHN LEVIN........................................................................ DIRECTOR	3.0 .......................2.0	X					0	0	0
(26) DENNIS P LUND MD........................................................................ DIRECTOR/CMO	50.0 .......................1.0	X	X				0	793,402	51,138
(27) SUE BOSTROM........................................................................ DIRECTOR	3.0 .......................0.0	X					0	0	0
(28) FRANK LEE........................................................................ DIRECTOR	3.0 .......................2.0	X					0	0	0
(29) JANESTA NOLAND MD........................................................................ DIRECTOR (UNTIL 12/31/15)	3.0 .......................0.0	X					0	0	0
(30) JOEL PODOLNY........................................................................ DIRECTOR (UNTIL 12/31/15)	3.0 .......................0.0	X					0	0	0
(31) MINDY ROGERS........................................................................ DIRECTOR	3.0 .......................2.0	X					0	0	0
(32) BILL THOMPSON........................................................................ DIRECTOR	3.0 .......................0.0	X					0	0	0
(33) JORGE TITINGER........................................................................ DIRECTOR	3.0 .......................0.0	X					0	0	0
(34) DAVID ENTWISTLE........................................................................ DIRECTOR (AS OF 7/5/16)	3.0 .......................0.0	X					0	0	0
(35) MARY LEONARD MD........................................................................ DIRECTOR (AS OF 7/1/16)	3.0 .......................0.0	X					0	0	0
(36) CHRISTIE COLEMAN........................................................................ DIRECTOR (AS OF 01/01/16)	3.0 .......................0.0	X					0	0	0
(37) JENNIFER JOHNSON........................................................................ DIRECTOR	3.0 .......................0.0	X					0	0	0
(38) AMIT SINHA........................................................................ DIRECTOR (AS OF 01/01/16)	3.0 .......................0.0	X					0	0	0
(39) JOHN WALKER........................................................................ DIRECTOR	3.0 .......................0.0	X					0	0	0
(40) ANNE MCCUNE........................................................................ CHIEF OPERATING OFFICER	50.0 .......................0.0		X				908,339	0	41,809
(41) DANA HAERING........................................................................ VP & CFO	50.0 .......................2.0		X				532,041	0	80,411
(42) MARK TORTORICH........................................................................ VP DESIGN, PLAN, CONSTRUCTION	25.0 .......................25.0			X			0	465,587	56,101
(43) EDWARD KOPETSKY........................................................................ VP & CIO	50.0 .......................1.0			X			853,966	0	67,389
(44) KIM ROBERTS........................................................................ CSO, CAO PHYSICIAN PRACTICE	25.0 .......................25.0			X			669,258	0	133,667
(45) SUSAN COSTELLO........................................................................ VP PATIENT CARE SRVCS & CNO	50.0 .......................0.0			X			708,233	0	79,518
(46) MICHAEL LANE........................................................................ VP-LPCH CONSTRUCTION IN ADMIN	50.0 .......................0.0			X			509,287	0	96,517
(47) CAMERON D'ALPE........................................................................ VP AMBULATORY SERVICES	50.0 .......................0.0			X			345,818	0	59,679
(48) HELEN WILMOT........................................................................ SHC ADMIN - COO	25.0 .......................25.0			X			0	519,295	62,269
(49) OWEN R AURELIO........................................................................ VP CLINICAL SERVICES	50.0 .......................0.0				X		476,496	0	44,258
(50) GREGORY J SOUZA........................................................................ VP HR	50.0 .......................0.0				X		535,083	0	40,026
(51) MARK AMEY........................................................................ CTO	50.0 .......................0.0				X		501,260	0	60,063
(52) CLAIRE MAILHOT........................................................................ DIRECTOR BUSINESS DEVELOPMENT	50.0 .......................0.0				X		459,409	0	53,286
(53) WARREN CHANDLER........................................................................ ASSISTANT CIO	50.0 .......................0.0				X		442,078	0	100,306
(54) CRAIG T ALBANESE........................................................................ VP OF QUALITY & PI	0.0 .......................50.0					X	0	559,271	71,691

(A) Name and business address	(B) Description of services	(C) Compensation
STANFORD HEALTH CARE, 300 PASTEUR DR STANFORD,CA94305	MED LAB/PURCH SVCS	127,382,092
DPR CONSTRUCTION INC, 1450 VETERANS BLVD REDWOOD CITY,CA94063	CONSTRUCTION	235,284,760
STANFORD UNIVERSITY, 450 SERRA MALL STANFORD,CA94303	PURCHASED SERVICES	102,811,698
MCKESSON HEALTH SOLUTIONS, 12748 COLLECTION CENTER DRIVE SAN FRANCISCO,CA94108	MEDICAL SUPPLIER	32,054,270
LEVEL 10 CONSTRUCTION, 1050 ENTERPRISE WAY SUITE 250 SUNNYVALE,CA94089	CONSTRUCTION	23,331,342
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 415

- 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

2015

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 (Form 990 or 990-EZ))

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 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2015

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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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 2015 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2014 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2015. 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—2014. 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—2015. 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—2014. 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) 2015

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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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 2015 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2014 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2015 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2014 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2015. 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—2014. 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) 2015

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 (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) 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 section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

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

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 9a) 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 9a) 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 section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b 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

Schedule A (Form 990 or 990-EZ) 2015

Page 5

Part IV

Supporting Organizations (continued)

Yes

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

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, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) 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) 2015

Page 6

Part V

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

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

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) 2015

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

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 2015 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-2015	(iii) Distributable Amount for 2015
1 Distributable amount for 2015 from Section C, line 6
2 Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions)
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......
e From 2014.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2015 distributable amount
i Carryover from 2010 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2015 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2015 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)
6 Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)
7 Excess distributions carryover to 2016. Add lines 3j and 4c.
8 Breakdown of line 7:
a
b
c Excess from 2013.......
d From 2014.......
e From 2015.......

Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015

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) 2015

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

2015

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 other 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) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015) 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) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 3

Name of organization LUCILE SALTER PACKARD CHILDREN'S HOSPITAL AT STANFORD		Employer identification number 77-0003859

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) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

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.) $ 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) (2015)

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

2015

Open to Public
Inspection

If the organization answered "Yes" on 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" on 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" on 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-.
1
2
3
4
5
6

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2015

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) 2012	(b) 2013	(c) 2014	(d) 2015	(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) 2015

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 on 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? .............................................................................

Yes

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

171,125

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

Yes

135,814

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

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

306,939

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 FY16, ROUGHLY 20% OF THE CHIEF GOVERNMENT RELATIONS OFFICER AND ROUGHLY 20% OF THE SENIOR POLICY MANAGER'S TIME WAS SPENT ON LOBBYING ON SPECIFIC LEGISLATIVE ISSUES - VALUE APPROXIMATELY $101,625 (INCLUDES DOLLARS ALLOCATED FOR BENEFITS). IN ADDITION, IN FY16, THE HOSPITAL HAD A LOBBYIST IN WASHINGTON D.C. AND A NON-LOBBYIST ADVOCATE IN SACRAMENTO. LPCH BELONGS TO CERTAIN TRADE ASSOCIATIONS, WITH A PORTION OF DUES PAID TO WHICH IS SPENT ON EFFORTS TO INFLUENCE LEGISLATIVE MATTERS IN THE HEALTH CARE INDUSTRY. DURING THE FY2016, THE APPROXIMATE AMOUNT OF THE DUES SPENT ON LOBBYING PURPOSES WAS $135,814.

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 FY16, ROUGHLY 20% OF THE CHIEF GOVERNMENT RELATIONS OFFICER AND ROUGHLY 20% OF THE SENIOR POLICY MANAGER'S TIME WAS SPENT ON LOBBYING ON SPECIFIC LEGISLATIVE ISSUES - VALUE APPROXIMATELY $101,625 (INCLUDES DOLLARS ALLOCATED FOR BENEFITS). IN ADDITION, IN FY16, THE HOSPITAL HAD A LOBBYIST IN WASHINGTON D.C. AND A NON-LOBBYIST ADVOCATE IN SACRAMENTO. LPCH BELONGS TO CERTAIN TRADE ASSOCIATIONS, WITH A PORTION OF DUES PAID TO WHICH IS SPENT ON EFFORTS TO INFLUENCE LEGISLATIVE MATTERS IN THE HEALTH CARE INDUSTRY. DURING THE FY2016, THE APPROXIMATE AMOUNT OF THE DUES SPENT ON LOBBYING PURPOSES WAS $135,814.

Schedule C (Form 990 or 990EZ) 2015

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," on 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

2015

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" on 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" on 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, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, 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" on 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 on 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 on 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) 2015

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" on 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


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

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" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....	307,571,000	308,872,000	280,799,140	266,394,140	270,361,140
b	Contributions ...	5,763,000	853,000	643,000	1,184,000	822,000
c	Net investment earnings, gains, and losses	8,643,000	12,649,000	42,123,000	29,497,000	8,136,000
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	15,693,000	14,803,000	14,693,140	16,276,000	12,925,000
f	Administrative expenses ....
g	End of year balance ......	306,284,000	307,571,000	308,872,000	280,799,140	266,394,140

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

69.000 %

Temporarily restricted endowment SchDMd Bullet

31.000 %

The percentages on 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" on 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' on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land ...	24,232,500		24,232,500
b	Buildings	442,247,732	178,881,107	263,366,625
c	Leasehold improvements	37,872,137	18,800,908	19,071,229
d	Equipment ...	303,298,316	192,982,457	110,315,859
e	Other ...	1,026,470,059	24,251,805	1,002,218,254
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				1,419,204,467

Schedule D (Form 990) 2015

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' on 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
(3)Other (A) INVESTMENTS IN UNIVERSITY MANA	608,364,863	F
(B) ASSETS LIMITED AS TO USE, HELD	218,871	F
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	608,583,734

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on 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

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes	0
DUE TO GOVERNMENT AGENCIES	1,849,249
DUE TO RELATED PARTIES, NET	17,359,005
SELF-INSURANCE RESERVE	41,448,190
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	60,656,444
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) 2015

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on 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' on 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

LUCILE SALTER PACKARD CHILDREN'S HOSPITAL ("LPCH") DOES NOT RECOGNIZE CONTRIBUTIONS OF WORKS OF ART ON LPCH'S FINANCIALS AS 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

LPCH'S ENDOWMENT FUNDS CONSIST 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) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on 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

2015

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) . . .		492	1,554,566		1,554,566	0.120 %
b	Medicaid (from Worksheet 3, column a) . . . . .		24,036	441,773,593	256,653,705	185,119,888	14.560 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .		24,528	443,328,159	256,653,705	186,674,454	14.680 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	16	3,538	3,102,653	25,880	3,076,773	0.240 %
f	Health professions education (from Worksheet 5) . . .	6	464	11,116,221		11,116,221	0.870 %
g	Subsidized health services (from Worksheet 6) . . . .	3		1,582,253	35,000	1,547,253	0.120 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	5	56,380	1,742,510	1,250	1,742,260	0.140 %
j	Total. Other Benefits . .	30	60,382	17,543,637	62,130	17,482,507	1.370 %
k	Total. Add lines 7d and 7j .	30	84,910	460,871,796	256,715,835	204,156,961	16.050 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2015

Schedule H (Form 990) 2015

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	58,008	58,008
3	Community support	2	1,373,892	1,373,892	0.110 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy	1	251,010	251,010	0.020 %
8	Workforce development	1	137,347	137,347	0.010 %
9	Other
10	Total	5	1,820,257	1,820,257	0.140 %

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. ......

977,783

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).....

3,275,461

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

10,226,357

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

-6,950,896

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) 2015

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 070000659	X	X

Schedule H (Form 990) 2015

Page 4

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 15

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

6 a

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): COMMUNITYBENEFIT.STANFORDCHILDRENS.ORG

Other website (list url):

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): COMMUNITYBENEFIT.STANFORDCHILDRENS.ORG

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

12b

If "Yes" on 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) 2015

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

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

Yes

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):

SEE PART V, SECTION C

The FAP application form was widely available on a website (list url):

SEE PART V, SECTION C

A plain language summary of the FAP was widely available on a website (list url):
SEE PART V, SECTION C

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) 2015

Page 6

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 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 19. (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) 2015

Page 7

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 2015, LUCILE SALTER PACKARD CHILDRENS HOSPITAL AT STANFORD (LPCH), IN COLLABORATION WITH LOCAL AREA NONPROFIT HOSPITAL ORGANIZATIONS AND THE 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 LUCILE SALTER PACKARD CHILDRENS HOSPITAL AT STANFORDS 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 COMMUNITY HEALTH NEEDS. THIS RESEARCH FOCUSED ON OUR 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. PRIMARY QUALITATIVE DATA (COMMUNITY INPUT) IN COOPERATION WITH THE AFOREMENTIONED CHNA COLLABORATIVE IN OUR PRIMARY SERVICE AREA OF SAN MATEO AND SANTA CLARA COUNTIES, LPCHS CHNA PROCESS COLLECTED QUALITATIVE DATA TO GATHER A NUANCED, MULTIFACETED VIEW OF THE MOST PRESSING HEALTH NEEDS IN THE TWO COUNTIES. IN BOTH COUNTIES, THREE STRATEGIES WERE UTILIZED FOR COLLECTING COMMUNITY INPUT: 1. INTERVIEWS WITH HEALTH EXPERTS (KEY INFORMANT INTERVIEWS) 2. FOCUS GROUPS WITH COMMUNITY LEADERS AND STAKEHOLDERS (FOCUS GROUPS AND COMMUNITY HEALTH NEEDS RANKING SURVEY) 3. FOCUS GROUPS WITH RESIDENTS (FOCUS GROUPS) TO PROVIDE A VOICE TO THE COMMUNITY, THE FOCUS GROUPS TARGETED RESIDENTS WHO WERE MEDICALLY UNDERSERVED, IN POVERTY, AND OF MINORITY POPULATIONS. THE RESEARCH IN BOTH SAN MATEO COUNTY (SMC) AND SANTA CLARA COUNTY (SCC) WAS FOCUSED ON TWO CORE QUESTIONS: 1. WHAT ARE THE TOP OR 'PRIORITY' HEALTH NEEDS IN THE COMMUNITY THAT ARE NOT BEING WELL MET NOW (COMPARED WITH 2013)? 2. WHAT ARE THE ISSUES AROUND ACCESS TO HEALTH CARE AND HOW HAS THE AFFORDABLE CARE ACT IMPACTED ACCESS TO HEALTH CARE FOR THE COMMUNITY? IN BOTH COUNTIES, INFORMANTS WERE ASKED TO IDENTIFY THE TOP NEEDS OF THEIR CONSTITUENCIES AND TO GIVE THEIR PERCEPTIONS ABOUT HOW ACCESS TO HEALTH CARE HAS CHANGED IN THE POST-ACA ENVIRONMENT. THE VARIOUS STRATEGIES UTILIZED TO GATHER THE NEEDED COMMUNITY INPUT ARE OUTLINED BELOW: 1. KEY INFORMANT INTERVIEWS: THE CHNA PROCESS INTERVIEWED VARIOUS PROFESSIONALS IN BOTH COUNTIES WHO EITHER WORK IN THE HEALTH FIELD OR IMPROVE HEALTH AND QUALITY OF LIFE CONDITIONS BY SERVING THOSE FROM IRS-IDENTIFIED, HIGH-NEED POPULATIONS AS WELL AS COMMUNITY LEADERS AND/OR REPRESENTATIVES. INTERVIEWS OCCURRED IN PERSON OR BY TELEPHONE FOR APPROXIMATELY ONE HOUR. IN BOTH COUNTIES, INFORMANTS WERE ASKED TO IDENTIFY THE TOP NEEDS OF THEIR CONSTITUENCIES AND TO GIVE THEIR PERCEPTIONS ABOUT HOW ACCESS TO HEALTH CARE HAS CHANGED IN THE POST-ACA ENVIRONMENT. THESE INTERVIEWS TOOK PLACE IN THE SPRING OF 2015. 2. COMMUNITY HEALTH NEEDS RANKING SURVEY: THE CHNA COLLABORATIVE INVITED 65 COMMUNITY LEADERS WITH EXPERTISE IN SERVING THE COMMUNITY TO PARTICIPATE IN AN ONLINE SURVEY IN JULY 2015. THE SURVEY ASKED PARTICIPANTS TO RANK A LIST OF HEALTH NEEDS IN SANTA CLARA COUNTY AND INVITED THEM TO ADD OTHER NEEDS TO THE LIST. FORTY-NINE LEADERS RESPONDED TO THE SURVEY, REFLECTING A WIDE RANGE OF EXPERTISE. PARTICIPANTS ORGANIZATIONS INCLUDED BEHAVIORAL HEALTH AGENCIES, AGENCIES THAT HELP FAMILIES WITH BASIC NEEDS, SCHOOL SYSTEMS AND OTHER NONPROFIT ORGANIZATIONS. ASR COMBINED THE RESULTS OF THE SURVEY WITH INPUT GATHERED THROUGH FOCUS GROUPS AND KEY INFORMANT INTERVIEWS TO DETERMINE THE COMMUNITYS PRIORITIES. 3. FOCUS GROUPS WITH HEALTH PROFESSIONALS AND RESIDENTS: FOCUS GROUP DISCUSSIONS IN BOTH COUNTIES INCLUDED 10 PEOPLE ON AVERAGE AND LASTED ONE HOUR. NONPROFIT HOSTS, INCLUDING THE COMMUNITY HEALTH PARTNERSHIP IN SAN JOSE (WHICH SERVES THE UNINSURED) AND MAPLE STREET SHELTER IN REDWOOD CITY (WHICH SERVES THOSE EXPERIENCING HOMELESSNESS) RECRUITED RESIDENTS. FOR INPUT FROM HEALTH EXPERTS AND THOSE WHO REPRESENT THE TARGET POPULATIONS, COLLABORATIVE MEMBERS RECRUITED FOCUS GROUP HOSTS AND PROFESSIONAL PARTICIPANTS FOR THE GROUPS BASED ON THEIR KNOWLEDGE OF THE COMMUNITY. ORGANIZATIONS CONSULTED IN ADDITION TO FOCUS GROUPS: ADOLESCENT COUNSELING SERVICES AMERICAN METHODIST EPISCOPAL ZION CHURCH CATHOLIC CHARITIES COASTSIDE HOPE COMMUNITY GATEPATH CONGREGATIONAL CHURCH OF SAN MATEO DALY CITY YOUTH FIRST 5 HEALTH CENTER HOME SAFETY SERVICES INNVISION - SHELTER NETWORK LESLEY SENIOR COMMUNITIES LGBTQ COMMISSION LINCOLN STREET CENTER MIDPEN RESIDENT SERVICES CORP. MILLS-PENINSULA HEALTH SERVICES AFRICAN AMERICAN COMMUNITY HEALTH ADVISORY COMMITTEE MULTICULTURAL INSTITUTE PENINSULA FAMILY SERVICE PENINSULA VOLUNTEERS MEALS ON WHEELS PUENTE RAVENSWOOD FAMILY HEALTH CENTER REDWOOD CITY FAIR OAKS COMMUNITY CENTER REDWOOD CITY PARKS, RECREATION AND COMMUNITY SERVICES SAMARITAN HOUSE SAN MATEO COUNTY BOARD OF SUPERVISORS SAN MATEO COUNTY HEALTH & HOSPITAL SYSTEM SAN MATEO COUNTY HEALTH DEPARTMENT SAN MATEO COUNTY HUMAN SERVICES AGENCY SAN MATEO JAPANESE-AMERICAN COMMUNITY CENTER SECOND HARVEST FOOD BANK SMC HEALTH SYSTEM (BHRS) SMC HEALTH SYSTEM; AGING AND ADULT SERVICES SOUTH SAN FRANCISCO PARKS/REC DEPARTMENT STARVISTA SYNERGY HOMECARE FURTHER DATA REGARDING THIS GATHERED COMMUNITY INPUT IS CONTAINED IN THE FULL CHNA AVAILABLE AT WWW.COMMUNITYBENEFITS.STANFORDCHILDRENS.ORG ALTHOUGH CONTACT INFORMATION FOR THE MANAGER OF COMMUNITY BENEFITS IS INCLUDED IN THE COMMUNITY BENEFIT REPORT AND ON THE COMMUNITYBENEFIT.STANFORDCHILDRENS.ORG WEBSITE, WE HAVE NOT RECEIVED WRITTEN COMMENTS TO-DATE.
PART V, SECTION B, LINE 6	LUCILE SALTER PACKARD CHILDRENS HOSPITAL AT STANFORDS (LPCH) MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (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, AND STANFORD HEALTH CARE. LPCHS MOST RECENT CHNA WAS CONDUCTED IN COLLABORATION WITH THE FOLLOWING ORGANIZATIONS THAT ARE NOT HOSPITAL FACILITIES: 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 SYSTEM, SAN MATEO COUNTY HEALTH DEPARTMENT AND SANTA CLARA COUNTY PUBLIC HEALTH DEPARTMENT.
PART V, SECTION B, LINE 11	LUCILE SALTER PACKARD CHILDREN'S HOSPITAL AT STANFORD(LPCH) IDENTIFIED FOURTEEN SIGNIFICANT COMMUNITY HEALTH NEEDS AND PRIORITIZED THREE AREAS TO FOCUS OUR WORK AND RESOURCES BASED ON: 1) THE MAGNITUDE OF THE HEALTH NEED, 2) THE EXISTENCE OF DISPARITIES OR INEQUITIES WITHIN THE AFFECTED POPULATION, 3) THE POSSIBLE EXISTENCE OF A MULTIPLIER EFFECT WHEN ADDRESSED, AND 4) OUR ABILITY TO LEVERAGE OUR EXPERTISE AND RESOURCES SO AS TO MAXIMIZE IMPACT. LPCH CHOSE TO PRIORITIZE THREE SIGNIFICANT HEALTH NEEDS BASED ON THESE FACTORS: SELECTED COMMUNITY HEALTH NEEDS 1) IMPROVE ACCESS TO PRIMARY HEALTH CARE SERVICES FOR CHILDREN, TEENS AND PREGNANT WOMEN (ACCESS & DELIVERY) 2) IMPROVE THE SOCIAL, EMOTIONAL AND MENTAL HEALTH OF CHILDREN AND YOUTH (BEHAVIORAL HEALTH) 3) PREVENT AND TREAT PEDIATRIC OBESITY (OBESITY) LPCH CONSIDERS THESE THREE COMMUNITY HEALTH NEEDS TO BE THE MAIN FOCUS OF OUR COMMUNITY BENEFIT WORK, SPECIFICALLY IN THE ARENA OF GRANT MAKING. OUR COMMUNITY INVESTMENT GRANTS FOR THE NEXT THREE YEARS WILL FOCUS PRIMARILY ON THE THREE COMMUNITY HEALTH NEEDS LISTED ABOVE. WE WILL DIRECT SUBSTANTIAL STAFF TIME AND FINANCIAL RESOURCES TO LOCAL COMMUNITY NONPROFITS WORKING ON PROJECTS OR OFFERING SERVICES IN AREAS THAT REFLECT A SHARED COMMITMENT TO IMPROVING THESE COMMUNITY HEALTH NEEDS. IN ADDITION, LPCH WILL CONTINUE TO LEVERAGE OUR RESOURCES AND EXPERTISE WHILE PARTNERING WITH OTHERS ON THE REMAINING IDENTIFIED COMMUNITY HEALTH NEEDS FOR THE LIFE OF THIS CHNA. MANY OF THE UNSELECTED SIGNIFICANT HEALTH NEEDS OVERLAP AND THUS WILL RECEIVE ATTENTION AS THE HOSPITAL CONDUCTS ITS WORK AROUND THE THREE PRIORITY AREAS IDENTIFIED ABOVE. ALL FOURTEEN IDENTIFIED HEALTH NEEDS WILL RECEIVE ATTENTION AND RESOURCES EITHER DIRECTLY OR INDIRECTLY. HEALTH NEEDS NOT SELECTED BY LPCHS IMPLEMENTATION STRATEGY: BIRTH OUTCOMES: AS A FREESTANDING CHILDRENS HOSPITAL OFFERING MATERNITY SERVICES, LUCILE SALTER PACKARD CHILDRENS HOSPITAL AT STANFORD (LPCH) IS HEAVILY INVESTED IN THE BIRTH OUTCOMES OF CHILDREN AND FAMILIES IN OUR COMMUNITY. HOWEVER, BIRTH OUTCOMES, A HIGH-RANKING PRIORITY HEALTH NEED DUE TO THE DISPARITIES THAT EXIST, HAS NOT BEEN SELECTED BECAUSE THE NECESSARY SERVICES ARE ALREADY PROVIDED PER THE LPCHS CORE MISSION TO CARE FOR EXPECTANT MOTHERS, BABIES, CHILDREN, AND ADOLESCENTS. FURTHERMORE, AS A SAFETY-NET HOSPITAL LPCH CARES FOR A HIGH PERCENTAGE OF MEDICAID PATIENTS THAT LIKELY COMPRISE A SIGNIFICANT PORTION OF THE COMMUNITY MEMBERS REPRESENTED IN THE IDENTIFIED HEALTH NEED. IN ADDITION, LPCH HAS EXTENSIVE INVOLVEMENT IN LOCAL AND NATIONAL INITIATIVES THAT SEEK TO IMPROVE BIRTH OUTCOMES ACROSS THE HEALTH CARE SPECTRUM. REMAINING HEALTH NEEDS: LPCH WILL NOT DIRECTLY DEDICATE COMMUNITY BENEFIT RESOURCES TO THE REMAINING TEN TOP HEALTH NEEDS BECAUSE THESE NEEDS RANKED LOWER ON THE SELECTION CRITERIA, AND THESE NEEDS MAY BE INDIRECTLY ADDRESSED BY OTHER HOSPITAL RESOURCES. FOR INSTANCE, LPCH FUNDS TRANSPORTATION SERVICES FOR CHILDREN TO RECEIVE CARE AT AREA HOSPITALS AND CLINICS. THESE SERVICES PROMOTE HEALTH ACCESS, BUT ALSO ADDRESS TRANSPORTATION, WHICH IS ANOTHER ONE OF THE TOP 14 HEALTH NEEDS. THE LIST BELOW SUMMARIZES LPCHS JUSTIFICATIONS FOR NOT SELECTING THE REMAINING TEN HEALTH NEEDS. THE CORRESPONDING HEALTH NEEDS HAVE BEEN GROUPED INTO THREE CATEGORIES BASED ON RATIONALE. SOME HEALTH NEEDS SPAN MULTIPLE RATIONALE CATEGORIES. 1. LPCH HAS EXISTING, ONGOING SERVICES AND PROGRAMS THAT DIRECTLY SEEK TO IMPROVE THE FOLLOWING HEALTH NEEDS: BIRTH OUTCOMES, ORAL/DENTAL HEALTH, RESPIRATORY CONDITIONS, VIOLENCE & ABUSE, LEARNING DISABILITIES, AND UNINTENTIONAL INJURIES. 2. LPCH HAS EXISTING, ONGOING COMMUNITY-BASED ACTIVITIES THAT ARE FREE AND OPEN TO THE PUBLIC OR SCHOLARSHIP OPPORTUNITIES BASED ON NEED EXIST: BIRTH OUTCOMES, SEXUAL HEALTH, AND UNINTENTIONAL INJURIES. 3. LPCH CONDUCTS ONGOING ADVOCACY EFFORTS ON THE LOCAL, STATE, AND NATIONAL LEVELS THROUGH DEDICATED STAFF AND RESOURCES AND THUS DID NOT SELECT THE FOLLOWING NEEDS: BIRTH OUTCOMES, CLIMATE CHANGE, ECONOMIC SECURITY, HOUSING & HOMELESSNESS, TRANSPORTATION & TRAFFIC, AND UNINTENTIONAL INJURIES
PART V, SECTION B, LINE 16A, 16B & 16C	LUCILE SALTER PACKARD CHILDREN'S HOSPITAL AT STANFORD (LPCH) MAKES ITS FAP, FAP APPLICATION AND PLAIN LANGUAGE SUMMARY AVAILABLE TO THE PUBLIC AT STANFORDCHILDRENS.ORG/EN/PATIENT-FAMILY-RESOURCES/FINANCIAL-ASSISTANCE-ENG LISH#TOPPICK
PART V, SECTION B, LINE 20A	FINANCIAL ASSISTANCE DISCUSSION OCCURS AT THE TIME OF ADMISSION WHEN THE PATIENT SPEAKS WITH A FINANCIAL COUNSELOR. FINANCIAL ASSISTANCE INFORMATION IS ALSO INCLUDED IN THE ADMISSION PACKETS PROVIDED TO PATIENTS.
PART V, SECTION B, LINE 20B	FINANCIAL ASSISTANCE DISCUSSION MAY ALSO OCCUR AT THE TIME OF DISCHARGE WITH A FINANCIAL COUNSELOR IF THE PATIENT EXPRESSES CONCERN ABOUT FINANCIAL LIABILITY.

Schedule H (Form 990) 2015

Page 8

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) 2015

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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)	IN FY16, THERE WAS A CREDIT BALANCE OF $3,621,420 IN PROVISION FOR DOUBTFUL ACCOUNTS. AS SUCH, THIS AMOUNT WAS ADDED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN LINE 7, COLUMN F PERCENT OF TOTAL EXPENSE. 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 COMMUNITYS HEALTH THROUGH A FOCUS ON THE ROOT CAUSES OF HEALTH PROBLEMS, SUCH AS POVERTY, ENVIRONMENTAL ISSUES, ETC. LPCHS COMMUNITY BUILDING ACTIVITIES INCLUDE: SUPPORT FOR COMMUNITY-BASED NON-PROFITS WORKING TO ADDRESS THE ROOT CAUSES OF HEALTH ISSUES FOR CHILDREN AND EXPECTANT MOTHERS; SUPPORT FOR COMMUNITY EMERGENCY MANAGEMENT, ADVOCACY FOR CHILDRENS 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 PROVISION FOR DOUBTFUL ACCOUNTS BASED ON CHARGES AS WAS APPLIED TO ITS CHARITY CARE BASED ON CHARGES. THE COST TO CHARGE RATIO FROM THE ORGANIZATIONS COST ACCOUNTING SYSTEM ADDRESSES ALL PATIENT SEGMENTS AND EXCLUDES RESEARCH AND SOME GRANT RELATED COSTS. PART III, LINE 4 THE ORGANIZATIONS FINANCIAL STATEMENTS DO NOT INCLUDE A SPECIFIC FOOTNOTE THAT DESCRIBES PROVISION FOR DOUBTFUL ACCOUNTS. IN THE CONTEXT OF DESCRIBING THE PROCESS FOR ESTIMATING THE ULTIMATE COLLECTABILITY OF PATIENT RECEIVABLES, THE FOOTNOTES STATE REVISIONS IN THE RESERVE FOR DOUBTFUL ACCOUNTS ARE RECORDED AS ADJUSTMENTS TO THE PROVISION FOR DOUBTFUL ACCOUNTS, OR BAD DEBT EXPENSE. INCLUDED IN THE ORGANIZATIONS 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	HE MEDICARE SHORTFALL OF ($6,950,896) 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	LPCH HAS A DEBT COLLECTION POLICY, WHICH PROVIDES INFORMATION REGARDING THE BILLING AND COLLECTION OF PATIENT DEBT, INCLUDING PATIENTS WHO QUALIFY UNDER FINANCIAL ASSISTANCE. THIS POLICY COMPLIES WITH CALIFORNIA HEALTH SAFETY CODE AND THE FEDERAL PATIENT PROTECTION AND AFFORDABLE CARE ACT. A. LPCH WILL PURSUE PAYMENT FOR DEBTS OWED FOR HEALTH CARE SERVICES PROVIDED BY LPCH ACCORDING TO LPCH POLICY AND PROCEDURES. THE PROCEDURES FOR ASSIGNMENT TO COLLECTIONS/BAD DEBT WILL BE APPLICABLE TO ALL LPCH GUARANTORS. B. LPCH WILL COMPLY WITH RELEVANT FEDERAL AND STATE LAWS AND REGULATIONS IN THE ASSIGNMENT OF BAD DEBT. C. ALL PATIENT ACCOUNT BALANCES THAT MEET THE FOLLOWING CRITERIA ARE ELIGIBLE FOR PLACEMENT WITH A COLLECTION AGENCY: 1. LPCH HAS MADE ATTEMPTS TO COLLECT PAYMENT USING REASONABLE COLLECTION EFFORTS. LPCH WILL ATTEMPT TO MAIL FOUR (4) GUARANTOR STATEMENTS AFTER THE DATE OF DISCHARGE FROM OUTPATIENT OR INPATIENT CARE, WITH A FINAL 10 DAY NOTICE APPEARING ON THE FOURTH GUARANTOR STATEMENT, INDICATING THE ACCOUNT MAY BE PLACED WITH A COLLECTION AGENCY. ALL BILLING STATEMENTS INCLUDE A NOTICE ABOUT THE LPCH FINANCIAL ASSISTANCE/CHARITY CARE POLICY. 2. ACCOUNTS WITH A RETURNED MAIL STATUS ARE ELIGIBLE FOR COLLECTIONS ASSIGNMENT AFTER ALL GOOD FAITH EFFORTS HAVE BEEN DOCUMENTED AND EXHAUSTED. 3. IF A PATIENT CURRENTLY HAS OTHER ACCOUNTS THAT ARE OPEN OR UNRESOLVED BAD DEBT BALANCES, LPCH RESERVES THE RIGHT TO SEND ACCOUNTS TO COLLECTIONS EARLIER. 4. LPCH WILL SUSPEND ANY AND ALL COLLECTION ACTIONS IF A COMPLETED FINANCIAL ASSISTANCE APPLICATION, INCLUDING ALL REQUISITE SUPPORTING DOCUMENTATION, IS RECEIVED. FURTHER, IF LPCH DETERMINES THE INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE, IT WILL PROMPTLY REFUND ANY OVERPAID AMOUNTS. D. AS STATED IN LPCHS FINANCIAL ASSISTANCE/CHARITY CARE POLICY, A PATIENT WHO QUALIFIES FOR A FINANCIAL HARDSHIP DISCOUNT, MAY NEGOTIATE AN EXTENDED INTEREST-FREE PAYMENT PLAN FOR ANY PATIENT OUT-OF-POCKET FEES. THE PAYMENT PLAN SHALL TAKE INTO ACCOUNT THE PATIENTS INCOME, ESSENTIAL LIVING EXPENSES, ASSETS, THE AMOUNT OWED, AND ANY PRIOR PAYMENTS. E. IF A GUARANTOR DISAGREES WITH THE ACCOUNT BALANCE, THE GUARANTOR MAY REQUEST THE ACCOUNT BALANCE BE RESEARCHED AND VERIFIED PRIOR TO ACCOUNT ASSIGNMENT TO A COLLECTION AGENCY.
PART VI, LINE 2	IN ADDITION TO CONDUCTING A TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENT AND AN ANNUAL IMPLEMENTATION STRATEGY REPORT, LUCILE SALTER PACKARD CHILDRENS HOSPITAL AT STANFORD (LPCH) PARTICIPATES IN NUMEROUS OTHER ENDEAVORS THAT SEEK TO INFORM OUR ASSESSMENT OF THE OVERALL HEALTH OF THE COMMUNITY WE SERVE. THOSE ENDEAVORS ARE LISTED BELOW: 1)LPCH IS A MEMBER OF TWO COLLABORATIVE GROUPS THAT SEEK TO IDENTIFY AND ADDRESS COMMUNITY HEALTH NEEDS AS THEIR MAIN FUNCTION: HEALTHY COMMUNITY COLLABORATIVE OF SAN MATEO COUNTY, AND SANTA CLARA COUNTY COMMUNITY BENEFIT COALITION. 2)LPCH HAS DEDICATED COMMUNITY BENEFIT STAFF THAT ACTIVELY ENGAGE WITH COMMUNITY NONPROFITS AND PUBLIC HEALTH DEPARTMENTS WORKING ON BOTH PUBLIC HEALTH AND SOCIAL DETERMINANTS OF HEALTH ISSUES. 3)LPCH IS A MEMBER OF MULTIPLE CHAMBERS OF COMMERCE, REGIONAL ECONOMIC DEVELOPMENT ASSOCIATIONS AND SERVICE CLUBS THAT SEEK TO SHARE KNOWLEDGE ABOUT THE OVERALL HEALTH OF OUR COMMUNITY AND TO ADVOCATE FOR CHANGE THAT SEEKS TO IMPROVE THE HEALTH OF OUR COMMUNITY. THE SILICON VALLEY COUNCIL OF NONPROFITS, A NONPROFIT ASSOCIATION THAT ADVOCATES FOR NONPROFIT SERVICES IS ONE EXAMPLE. 4)LPCH HAS DEDICATED ADVOCACY STAFF THAT WORKS WITH COMMUNITY LEADERS, ELECTED OFFICIALS, AND ADVOCACY ORGANIZATIONS IN ORDER TO INFORM OUR UNDERSTANDING OF THE HEALTH OF OUR COMMUNITY AS WELL AS LARGER NATIONWIDE ISSUES. 5)LPCH LEADERSHIP PLAYS PIVOTAL ROLES ON VARIOUS BOARDS AND COMMITTEES IN THE COMMUNITY AND ACROSS THE NATION THAT INFORMS OUR UNDERSTANDING OF THE HEALTH OF OUR COMMUNITY AS WELL AS NATIONWIDE ISSUES. 6)LPCH HAS A DEEP RELATIONSHIP WITH STANFORD UNIVERSITY SCHOOL OF MEDICINE THAT INFORMS OUR UNDERSTANDING OF THE HEALTH OF OUR COMMUNITY AND THE NATION VIA ACCESS TO WORLD-RENOWNED FACULTY AND RESEARCH.
PART VI, LINE 3	THE 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 AREA TRAINED TO DIRECT PATIENTS TO THE FINANCIAL COUNSELING DEPARTMENT. 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 AND 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 DEBT COLLECTION POLICY, FINANCIAL ASSET APPLICATION, FINANCIAL ASSISTANCE PLAN LANGUAGE SUMMARY, THE UNINSURED PATIENT DISCOUNT POLICY, THE AVAILABILITY OF SUCH ASSISTANCE AND COUNTS, 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	LUCILE SALTER PACKARD CHILDRENS HOSPITAL AT STANFORD (LPCH) IS LOCATED ON THE STANFORD UNIVERSITY CAMPUS IN PALO ALTO, CALIFORNIA. PALO ALTO IS LOCATED ON THE NORTHERN END OF SANTA CLARA COUNTY (SCC), BORDERING THE SAN MATEO COUNTY (SMC) CITIES OF EAST PALO ALTO TO THE EAST AND MENLO PARK TO THE NORTH. BECAUSE OF OUR INTERNATIONAL REPUTATION FOR OUTSTANDING CARE TO BABIES, CHILDREN, ADOLESCENTS AND EXPECTANT MOTHERS, WE SERVE PATIENTS AND THEIR FAMILIES AROUND THE ENTIRE SAN FRANCISCO BAY AREA. IN THE 10-COUNTY NORTHERN CALIFORNIA AREA, LPCH RANKS FIRST FOR PEDIATRICS, WITH 12 PERCENT MARKET SHARE, AND FIFTH FOR OBSTETRICS, WITH 4 PERCENT MARKET SHARE. HOWEVER, AS OUR 2015 DISCHARGE DATA SHOW THAT OVER HALF (51 PERCENT) OF LPCHS INPATIENT PEDIATRIC CASES (EXCLUDING NORMAL NEWBORNS) AND 85 PERCENT OF OBSTETRICS CASES COME FROM SANTA CLARA COUNTY (SCC) AND SAN MATEO COUNTY (SMC), THE PRIMARY COMMUNITY WE SERVE CAN BE DEFINED AS SCC AND SMC. A DESCRIPTION OF THE COMMUNITY WE SERVE DISAGGREGATED BY COUNTY IS BELOW. SAN MATEO COUNTY: SAN MATEO COUNTY, LOCATED ON THE SAN FRANCISCO PENINSULA, IS MADE UP OF 20 CITIES AND TOWNS, BORDERED BY THE CITY AND COUNTY OF SAN FRANCISCO TO THE NORTH AND SANTA CLARA COUNTY TO THE SOUTH. SMC IS A MIX OF URBAN AND SUBURBAN INDUSTRIAL, SMALL BUSINESS AND RESIDENTIAL USE. THE COASTAL AREA IS A MIX OF SUBURBAN AND RURAL AREAS WITH SIGNIFICANT AGRICULTURAL, FISHING, SMALL BUSINESS AND TOURISM LAND USE. ACCORDING TO THE U.S. CENSUS, THE ESTIMATED POPULATION OF THE COUNTY IN 2014 WAS 739,837. SMCS POPULATION IS EXPECTED TO INCREASE BY 14 PERCENT BETWEEN 2010 AND 2050. SMC IS AMONG THE RICHEST COUNTIES IN TERMS OF ETHNIC DIVERSITY. MORE THAN HALF (56 PERCENT) OF THE SMC POPULATION IS WHITE, WHICH IS EXPECTED TO DECREASE OVER THE NEXT FOUR DECADES BY NEARLY 50 PERCENT. CURRENTLY, ONE-QUARTER OF THE POPULATION (26 PERCENT) IS ASIAN AND 3 PERCENT ARE BLACK/AFRICAN AMERICAN. APPROXIMATELY 8 PERCENT SELECTED 'SOME OTHER RACE5 PERCENT SELECTED 'MORE THAN ONE RACE.' IN SMC THE LARGEST SUBGROUPS OF ASIAN RESIDENTS ARE CHINESE AND FILIPINO (A COMBINED 38 PERCENT OF THE ASIAN POPULATION), FOLLOWED BY THE ASIAN INDIAN GROUP (28 PERCENT). MORE THAN A QUARTER (27 PERCENT) REPORTED BEING OF LATINO ETHNICITY (DISTINCT FROM RACE). ONE-THIRD (34 PERCENT) OF THE COUNTY POPULATION IS FOREIGN-BORN, AND NEARLY HALF (46 PERCENT) OF THOSE AGED 5 AND OLDER SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME. IN SMC, APPROXIMATELY 34 PERCENT OF THE POPULATION WAS BORN OUTSIDE OF THE UNITED STATES. BY THE YEAR 2050, THE ETHNIC MAKEUP OF THE COUNTY IS PROJECTED TO BE 38 PERCENT HISPANIC, 32 PERCENT ASIAN/PACIFIC ISLANDER, 22 PERCENT WHITE, 5 PERCENT BLACK/AFRICAN AMERICAN AND 4 PERCENT OTHER/MULTI-RACE. LESS THAN ONE-QUARTER (24 PERCENT) OF THE RESIDENTS IN SAN MATEO COUNTY ARE UNDER THE AGE OF 20, WHILE 35 PERCENT ARE BETWEEN THE AGES OF 20 AND 44, AND THE REST (41 PERCENT) OF THE RESIDENTS ARE OVER THE AGE OF 44. THE ETHNIC MAKEUP OF CHILDREN AGED 14 AND YOUNGER IS PROJECTED TO BE HISPANIC, ASIAN/PACIFIC ISLANDER, WHITE, BLACK/ AFRICAN AMERICAN AND MULTI-RACE IN 2050. THE U.S. CENSUS BUREAU ESTIMATES THAT IN 2014, THE MEDIAN INCOME FOR SMC RESIDENTS WAS $91,421. WHILE THIS MEDIAN INCOME IS THE THIRD HIGHEST IN CALIFORNIA, ONE IN 10 CHILDREN AGED 18 AND YOUNGER LIVE BELOW THE FEDERAL POVERTY LEVEL (FPL), AND 8 PERCENT OF ALL OF SMC INDIVIDUALS LIVE BELOW FPL. THERE ARE RACE/ETHNIC DISPARITIES IN THE PERCENTAGE OF CHILDREN LIVING BELOW 100 PERCENT OF FPL. BLACK AND LATINO CHILDREN IN BOTH SMC AND SCC ARE ALMOST FIVE TIMES MORE LIKELY THAN WHITE CHILDREN TO LIVE IN POVERTY. HOWEVER, BECAUSE FPL DOES NOT TAKE INTO CONSIDERATION LOCAL CONDITIONS SUCH AS COST OF LIVING, AGENCIES USE OTHER MEASURES OF ECONOMIC SECURITY TO PROVIDE A MORE REALISTIC MEASURE OF POVERTY IN SMC. ACCORDING TO THE 2014 FAMILY SELF-SUFFICIENCY STANDARD (FSSS), A SINGLE PARENT WITH TWO CHILDREN LIVING IN SMC MUST EARN APPROXIMATELY $97,200 ANNUALLY TO MEET THE FAMILYS BASIC NEEDS, THE EQUIVALENT OF FIVE FULL-TIME MINIMUM-WAGE JOBS IN SMC. SANTA CLARA COUNTY: WITH 1.8 MILLION RESIDENTS, SANTA CLARA COUNTY IS THE SIXTH MOST POPULATED OF CALIFORNIAS 58 COUNTIES, AND THE MOST POPULATED COUNTY IN THE BAY AREA. MORE THAN HALF OF THE RESIDENTS LIVE IN SAN JOSE. SCCS POPULATION IS PROJECTED TO GROW FROM THE CURRENT LEVEL TO MORE THAN 2.2 MILLION BY 2030. THE NORTH COUNTY AREA IS EXTENSIVELY URBANIZED. THIRTEEN OF THE COUNTYS 15 CITIES AND MORE THAN 88 PERCENT OF THE COUNTYS RESIDENTS LIVE IN THE NORTH COUNTY. GILROY AND MORGAN HILL, WITH APPROXIMATELY 5 PERCENT OF THE COUNTYS POPULATION, ARE LOCATED IN THE SOUTH COUNTY, WHICH REMAINS PREDOMINANTLY RURAL WITH LOW-DENSITY RESIDENTIAL DEVELOPMENTS SCATTERED THOUGH THE VALLEY AND FOOTHILL AREAS. ACCORDING TO U.S. CENSUS 2014 ESTIMATES, APPROXIMATELY 37 PERCENT OF THE POPULATION IN SCC WAS BORN OUTSIDE OF THE UNITED STATES, OUTPACING THE RATE FOR CALIFORNIA BY NEARLY 10 PERCENT. OF THOSE WHO REPORT ONE RACE, NEARLY HALF (49 PERCENT) ARE WHITE ALONE, 33 PERCENT ARE ASIAN, AND 3 PERCENT ARE BLACK/AFRICAN-AMERICAN. APPROXIMATELY 10 PERCENT SELECTED SOME OTHER RACE AND 5 PERCENT SELECTED MORE THAN ONE RACE. THE PREDOMINANT SUB-GROUPS OF THE ASIAN POPULATION ARE CHINESE (27 PERCENT), VIETNAMESE (22 PERCENT), ASIAN INDIAN (22 PERCENT) AND FILIPINO (15 PERCENT). MORE THAN ONE IN FOUR RESIDENTS (27 PERCENT) REPORTED A HISPANIC/LATINO ETHNICITY (DISTINCT FROM RACE). SCC RESIDENTS IN TOTAL SPEAK MORE THAN 100 LANGUAGES AND DIALECTS. LATINOS REPRESENT THE FASTEST-GROWING DEMOGRAPHIC. ACCORDING TO THE 2012 SILICON VALLEY LATINO REPORT CARD, 82 PERCENT OF LATINOS (BOTH NATIVE-BORN AND FOREIGN-BORN) IN SILICON VALLEY ARE FROM MEXICO, WITH ANOTHER 8.5 PERCENT FROM CENTRAL AMERICA. THE VIETNAMESE POPULATION IS ANOTHER DEMOGRAPHIC THAT IS GROWING RAPIDLY IN SCC. WHILE THERE ARE CURRENTLY MORE CHINESE (27 PERCENT) IN SCC THAN VIETNAMESE (22 PERCENT), THE VIETNAMESE POPULATION HAS GROWN VERY QUICKLY IN THE LAST FEW DECADES, FROM 11,717 IN 1980 TO 134,525 IN 2010. THE POPULATION IS THE SECOND LARGEST OF ANY COUNTY IN THE UNITED STATES, SURPASSED ONLY BY ORANGE COUNTY, CALIFORNIA. SAN JOSE HAS THE LARGEST VIETNAMESE POPULATION OF ANY US CITY. THE SCC MEDIAN INCOME IN 2014 WAS $93,854 -THE HIGHEST IN CALIFORNIA. HOWEVER, LIKE SMC, ONE IN 10 SCC CHILDREN AND 14 PERCENT OF ADULTS WERE LIVING BELOW FPL IN 2014. IN ADDITION, MORE HISPANIC/LATINO AND BLACK/AFRICAN-AMERICAN CHILDREN ARE LIVING IN POVERTY COMPARED WITH CHILDREN OF OTHER RACIAL OR ETHNIC GROUPS AND THE COUNTY OVERALL. IN SCC, A SINGLE PARENT WITH TWO CHILDREN MUST EARN APPROXIMATELY $90,700 ANNUALLY TO MEET THE FAMILYS BASIC NEEDS, THE EQUIVALENT OF FOUR FULL-TIME SCC MINIMUM WAGE JOBS.
PART VI, LINE 5	LUCILE SALTER PACKARD CHILDRENS HOSPITAL AT STANFORD (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 FY2016 COMMUNITY BENEFIT REPORT AND IMPLEMENTATION PLAN FILED FEBRUARY 2017 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 LPCHS 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 COLLABORATIVE WORKING ON MATERNAL AND PEDIATRIC HEALTH. COMMUNITY HEALTH IMPROVEMENT THE HOSPITAL CONDUCTS MULTIPLE PROGRAMS THAT ARE OFFERED AT NO COST TO COMMUNITY MEMBERS AND SEEKS 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. ACADEMIC MEDICAL CENTER RESEARCH LPCH IS PART OF STANFORD UNIVERSITY SCHOOL OF MEDICINE, THE WEST COASTS OLDEST MEDICAL SCHOOL AND WORLDWIDE LEADER IN PATIENT CARE, EDUCATION, RESEARCH, AND INNOVATION. LPCH IS PROUD TO BE THE PRIMARY TEACHING HOSPITAL OF STANFORD UNIVERSITY SCHOOL OF MEDICINE, ONE OF THE TOP RANKED ACADEMIC MEDICAL INSTITUTIONS IN THE COUNTRY. THROUGHOUT HISTORY, STANFORD UNIVERSITY SCHOOL OF MEDICINE HAS BEEN HOME TO CUTTING-EDGE MEDICAL ADVANCES, INCLUDING THE FIRST SUCCESSFUL ADULT HUMAN HEART TRANSPLANT IN THE COUNTRY AND THE FIRST COMBINED HEART-LUNG TRANSPLANT IN THE WORLD. LUCILE PACKARD CHILDRENS HOSPITAL STANFORD FUNDS ONGOING RESEARCH THROUGH STANFORD UNIVERSITY SCHOOL OF MEDICINE THAT SEEKS TO IMPROVE THE HEALTH OF OUR COMMUNITY. PART VI, LINE 7 LUCILE SALTER PACKARD CHILDRENS HOSPITAL AT STANFORD (LPCH) FILES AN ANNUAL COMMUNITY BENEFIT REPORT AND IMPLEMENTATION PLAN WITH THE CALIFORNIA OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT AS REQUIRED BY STATE LAW, SB 697 (TORRES, 1994).

Schedule H (Form 990) 2015

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," on 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

2015

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" on 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	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of non-cash assistance	(h) Purpose of grant or assistance

(1) EATING DISORDER RESOURCE CENTER 15891 LOS GATOS-ALMADEN ROAD LOS GATOS,CA95008	68-0616393	501(c)(3)	20,000	EATING DISORDER PROGRAM
(2) RAVENSWOOD FAMILY HEALTH CENTER 1885 BAY RD EAST PALO ALTO,CA94303	94-3372130	501(c)(3)	416,144	SUPPORT RAVENSWOOD HEALTH EFFORTS
(3) SAN MATEO COUNTY CHILDREN'S HEALTH INITIATI 222 W 39TH AVE SAN MATEO,CA94403	94-6000532	Government	325,000	SUPPORT THE SAN MATEO COUNTY CHILDREN'S HEALTH INITIATIVE COMMUNITY OUTREACH GRANT AND THE LABOR, DELIVERY AND PRENATAL SERVICES PROJECT
(4) PUENTE 620 NORTH STREET PESCADERO,CA94060	37-1484262	501(C)(3)	32,500	Support for care coordination for South San Mateo County Coastside residents
(5) MAYVIEW COMMUNITY HEALTH CENTER 670 GRANT AVE PALO ALTO,CA94306	94-2239648	501(C)(3)	25,000	Community Benefit grant.
(6) YMCA OF SILICON VALLEY 80 SARATOGA AVENUE SANTA CLARA,CA95051	94-1156318	501(c)(3)	36,500	SUPPORT EDUCATION EFFORTS
(7) MARCH OF DIMES 1101 S WINCHESTER BLVD SAN JOSE,CA95128	13-1846366	501(C)(3)	18,788	SPONSORSHIP
(8) SOUTH SAN FRANCISCO CONFERENCE CENTER 255 SOUTH AIRPORT BLVD S SF,CA94080	94-3167614	GOVERNMENT	60,000	SUPPORT THE ADOLESCENT MENTAL WELLNESS CONFERENCE
(9) CHALLENGE SUCCESS PO BOX 20053 STANFORD,CA94309	45-3767621	C CORPORATION	25,000	SUPPORT THE SOCIAL AND EMOTIONAL HEALTH OF YOUTH AND ADOLESCENTS
(10) GEORGE MARK CHILDRENS FUND 2121 GEORGE MARK LANE SAN LEANDRO,CA94578	94-3255845	501(c)(3)	10,000	SUPPORT THE GEORGE MARK CHILDRENS FUND
(11) HEALTH IMPROVEMENT PARTNERSHIP OF SANTA CRUZ COUNT 1800 GREEN HILLS RD 100 SCTTS VLY,CA95066	01-0826156	C CORPORATION	20,000	SUPPORT HIP'S EFFORTS
(12) JACOBS HEART CHILDRENS CANCER SUPPORT SERVICES 680 WEST BEACH STREET WATSONVILLE,CA95076	68-0413822	501(C)(3)	9,822	PALLIATIVE CARE MEETING
(13) LEGAL AID SOCIETY OF SAN MATEO COUNTY 330 TWIN DOLPHIN DRIVE SUITE 123 REDWOOD CITY,CA94065	94-1451894	501(c)(3)	35,000	SUPPORT THE FAMILY ADVOCACY PROGRAM
(14) PEER HEALTH EXCHANGE INC 70 GOLD STREET SAN FRANCISCO,CA94133	56-2374305	C CORPORATION	27,500	SUPPORT HEALTH EDUCATION EFFORTS
(15) UNITED WAY OF SANTA CRUZ COUNTY 4450 CAPITOLA ROAD CAPITOLA,CA95010	94-1422471	501(c)(3)	55,000	SUPPORT THE HEALTH PROGRAM EDUCATION EFFORTS

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) 2015

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on 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

(1)
(2)
(3)
(4)
(5)
(6)
(7)

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 UNYTED 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) 2015

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" on 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

2015

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 on 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 on 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 on 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," on line 5a or 5b, describe in Part III.

For persons listed on 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," on line 6a or 6b, describe in Part III.

For persons listed on 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 on 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" on 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) 2015

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 on 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 on 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)
1CHRISTOPHER G DAWESPRESIDENT/CEO	(i) (ii)	920,060 ------------- 0	483,212 ------------- 0	204,584 ------------- 0	436,532 ------------- 0	36,981 ------------- 0	2,081,369 ------------- 0	0 ------------- 0
2THOMAS KRUMMEL MDDIRECTOR	(i) (ii)	0 ------------- 597,377	0 ------------- 503,624	0 ------------- 5,251	0 ------------- 26,500	0 ------------- 19,574	0 ------------- 1,152,326	0 ------------- 0
3CHRISTY SANDBORG MDDIRECTOR	(i) (ii)	0 ------------- 249,352	0 ------------- 175,087	0 ------------- 0	0 ------------- 24,779	0 ------------- 25,767	0 ------------- 474,985	0 ------------- 0
4HUGH O'BRODOVICH MDDIRECTOR (UNTIL 06/30/16)	(i) (ii)	0 ------------- 502,440	0 ------------- 222,500	0 ------------- 24,058	0 ------------- 26,500	0 ------------- 21,015	0 ------------- 796,513	0 ------------- 0
5OWEN R AURELIOVP CLINICAL SERVICES	(i) (ii)	84,047 ------------- 0	0 ------------- 0	392,449 ------------- 0	33,471 ------------- 0	10,787 ------------- 0	520,754 ------------- 0	0 ------------- 0
6MARK TORTORICHVP DESIGN, PLAN, CONSTRUCTION	(i) (ii)	0 ------------- 307,169	0 ------------- 93,373	0 ------------- 65,045	0 ------------- 24,663	0 ------------- 31,438	0 ------------- 521,688	0 ------------- 0
7GREGORY J SOUZAVP HR	(i) (ii)	333,740 ------------- 0	131,166 ------------- 0	70,177 ------------- 0	36,750 ------------- 0	3,276 ------------- 0	575,109 ------------- 0	0 ------------- 0
8EDWARD KOPETSKYVP & CIO	(i) (ii)	461,170 ------------- 0	205,675 ------------- 0	187,121 ------------- 0	36,550 ------------- 0	30,839 ------------- 0	921,355 ------------- 0	115,355 ------------- 0
9AMIR DAN RUBINDIRECTOR (UNTIL 01/03/16)	(i) (ii)	0 ------------- 1,830,198	0 ------------- 1,162,531	0 ------------- 336,428	0 ------------- 329,395	0 ------------- 40,355	0 ------------- 3,698,907	0 ------------- 283,726
10KIM ROBERTSCSO, CAO PHYSICIAN PRACTICE	(i) (ii)	496,757 ------------- 0	106,501 ------------- 0	66,000 ------------- 0	94,813 ------------- 0	38,854 ------------- 0	802,925 ------------- 0	36,085 ------------- 0
11LLOYD B MINOR MDDIRECTOR	(i) (ii)	0 ------------- 1,385,420	0 ------------- 200,000	0 ------------- 131,255	0 ------------- 308,873	0 ------------- 37,682	0 ------------- 2,063,230	0 ------------- 0
12ANNE MCCUNECHIEF OPERATING OFFICER	(i) (ii)	542,301 ------------- 0	145,226 ------------- 0	220,812 ------------- 0	13,171 ------------- 0	28,638 ------------- 0	950,148 ------------- 0	129,233 ------------- 0
13DANA HAERINGVP & CFO	(i) (ii)	405,162 ------------- 0	117,573 ------------- 0	9,306 ------------- 0	68,671 ------------- 0	11,740 ------------- 0	612,452 ------------- 0	0 ------------- 0
14SUSAN COSTELLOVP PATIENT CARE SRVCS & CNO	(i) (ii)	243,401 ------------- 0	0 ------------- 0	464,832 ------------- 0	60,980 ------------- 0	18,538 ------------- 0	787,751 ------------- 0	0 ------------- 0
15MICHAEL LANEVP-LPCH CONSTRUCTION IN ADMIN	(i) (ii)	442,951 ------------- 0	63,145 ------------- 0	3,191 ------------- 0	88,654 ------------- 0	7,863 ------------- 0	605,804 ------------- 0	0 ------------- 0
16CAMERON D'ALPEVP AMBULATORY SERVICES	(i) (ii)	280,456 ------------- 0	61,530 ------------- 0	3,832 ------------- 0	46,537 ------------- 0	13,142 ------------- 0	405,497 ------------- 0	3,531 ------------- 0
17MARK AMEYCTO	(i) (ii)	313,525 ------------- 0	125,219 ------------- 0	62,516 ------------- 0	36,000 ------------- 0	24,063 ------------- 0	561,323 ------------- 0	0 ------------- 0
18DENNIS P LUND MDDIRECTOR/CMO	(i) (ii)	0 ------------- 288,544	0 ------------- 480,310	0 ------------- 24,548	0 ------------- 0	0 ------------- 51,138	0 ------------- 844,540	0 ------------- 0
19CLAIRE MAILHOTDIRECTOR BUSINESS DEVELOPMENT	(i) (ii)	190,783 ------------- 0	0 ------------- 0	268,626 ------------- 0	42,000 ------------- 0	11,286 ------------- 0	512,695 ------------- 0	0 ------------- 0
20WARREN CHANDLERASSISTANT CIO	(i) (ii)	323,318 ------------- 0	118,760 ------------- 0	0 ------------- 0	42,000 ------------- 0	58,306 ------------- 0	542,384 ------------- 0	0 ------------- 0
21CRAIG T ALBANESEVP OF QUALITY & PI	(i) (ii)	0 ------------- 308,448	0 ------------- 250,823	0 ------------- 0	0 ------------- 26,500	0 ------------- 45,191	0 ------------- 630,962	0 ------------- 0
22HELEN WILMOTSHC ADMIN - COO	(i) (ii)	0 ------------- 390,782	0 ------------- 76,216	0 ------------- 52,297	0 ------------- 23,850	0 ------------- 38,419	0 ------------- 581,564	0 ------------- 0

Schedule J (Form 990) 2015

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
HOUSING	SCHEDULE J, PART I, LINE 1A ONE OFFICER 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 SUSAN COSTELLO, SHE RECEIVED A LUMP SUM PAYMENT OF $396,552. UNDER THE TERMS OF A SEVERANCE ARRANGEMENT WITH OWEN AURELIO, HE RECEIVED A LUMP SUM PAYMENT OF $284,336. UNDER THE TERMS OF A SEVERANCE ARRANGEMENT WITH CLAIRE MAILHOT, SHE RECEIVED A LUMP SUM PAYMENT OF $268,626.
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. THE LAST DAY 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 2015: CHRISTOPHER DAWES 159,626 ANNE MCCUNE 196,942 DANA HAERING 7,289 KIM ROBERTS 36,561 CAMERON D'ALPE 3,832 EDWARD KOPETSKY 172,019 GREGORY J. SOUZA 44,297 OWEN R AURELIO 7,073 AMIR DAN RUBIN 300,132 MARK TORTORICH 40,670 FOR CERTAIN INDIVIDUALS LISTED ON SCHEDULE J, PART II, AMOUNTS CREDITED UNDER 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; (4) AUGUST 31, 2016 PROVIDED MR. DAWES REMAINS EMPLOYED AT THAT DATE. The credit to Mr. Dawes for calendar year 2015 of $400,000 is included in Sch J, Part II, Col 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 OTHER 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' (I.E. COMPUTERS AND PERIPHERALS) TO THE ABOVE LISTED EMPLOYEES PRINCIPALLY FOR THEIR BUSINESS USE.

Schedule J (Form 990) 2015

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

2015

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 FINANCING AUTHORITY	52-1643828	13033LWR4	03-21-2012	270,684,581	SEE PART VI		X		X		X
B	CALIFORNIA HEALTH FACILITES FINANCING AUTHORITY	52-1643828	13033L3G0	05-08-2014	208,381,669	FINANCE HEALTH FACILITIES		X		X		X
C	CALIFORNIA HEALTH FACILITES FINANCING AUTHORITY	52-1643828	13032UDC9	03-31-2016	206,377,852	SEE PART VI		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	0		0		0
2 Amount of bonds legally defeased ..............	0		0		0
3 Total proceeds of issue ..................	270,684,581		208,381,669		206,377,852
4 Gross proceeds in reserve funds .............	0		0		0
5 Capitalized interest from proceeds .............	2,021,018		12,264,663		3,784,033
6 Proceeds in refunding escrows ...............	0		0		91,100,236
7 Issuance costs from proceeds ...............	2,687,575		1,996,822		2,018,933
8 Credit enhancement from proceeds .............	0		0		0
9 Working capital expenditures from proceeds .............	0		0		0
10 Capital expenditures from proceeds .............	210,635,687		206,854,413		113,321,628
11 Other spent proceeds .............	92,902,864		0		810,236
12 Other unspent proceeds .............	0		0		0
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) 2015

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?
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		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) 2015

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 I, LINE A, COLUMN F

FINANCE HEALTH FACILITIES AND REDEMPTION OF 2003 SERIES C BONDS. SCHEDULE K, PART I, LINE C, COLUMN F FOR LEGAL DEFEASANCE AND REDEMPTION OF THE 2008 SERIES A, B, C REVENUE BONDS. SCHEDULE K, PART II, LINE 2, COLUMN C (2016 BONDS) THE 2016 BONDS WERE COMPRISED OF SERIES A AND B REVENUE BONDS. PROCEEDS OF THE 2016 SERIES A WERE USED FOR THE LEGAL DEFEASANCE AND REDEMPTION OF THE 2008 SERIES A, B, AND C REVENUE BONDS. PROCEEDS OF THE 2016 SERIES B WERE USED TO FINANCE A PORTION OF THE ONGOING CONSTRUCTION, AND EXPANSION OF THE HOSPITAL, AND TO PAY FOR THE COST OF ISSUANCE. SCHEDULE K, PART II, LINE 15, COLUMN A (2012 BONDS) THE 2012 BONDS WERE COMPRISED OF SERIES A AND B REVENUE BONDS. THE PROCEEDS OF THE 2012 SERIES B BONDS WERE USED TO REFUND, ON AN ADVANCED BASIS, THE SERIES 2003C BONDS. SCHEDULE K, PART II, LINE 15, COLUMN C (2016 BONDS) THE PROCEEDS OF THE 2016 SERIES A BONDS WERE USED TO REFUND, ON AN ADVANCE BASIS, THE 2008 SERIES BONDS. SCHEDULE K, PART IV, LINE 2C AN ARBITRAGE REBATE ANALYSIS WAS PERFORMED FOR 2008 SERIES A, B, AND C BONDS AND 2012 SERIES A AND B BONDS ON APRIL 17, 2016. THE DATES OF THE ANALYSIS IS PROVIDED BELOW. NO PAYMENT WAS DUE TO THE IRS FOR THESE BONDS IN FY2016 BOND A ARBITRAGE ANALYSIS OPINION LETTER ISSUED ON 9/26/2013 FOR BOND A. BOND B ARBITRAGE ANAYLSIS OPINION LETTER ISSUED ON 4/4/2013 FOR BOND B.

Schedule K (Form 990) 2015

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

2015

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) 2015

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	83,670	EMPLOYEE COMPENSATION		No
(2) ANGELA KOPETSKY	SEE PART V	160,614	EMPLOYEE COMPENSATION		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. ANGELA KOPETSKY: EMPLOYEE IS A FAMILY MEMBER OF A KEY EMPLOYEE.

Schedule L (Form 990 or 990-EZ) 2015

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

2015

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 PURPOSES OF LUCILE SALTER PACKARD CHILDREN'S HOSPITAL AT STANFORD ("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 ("SOM"), 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 SCHOOL OF MEDICINE AND SHC. FORM 990, PART III, LINE 4A PROGRAM SERVICE DESCRIPTION THE JOHNSON CENTER OF EXCELLENCE EXPENSE $376,535,000 GRANTS $0 REVENUE $390,895,000 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 STRONG SUPPORT FROM LOCAL PROVIDERS, OBSTETRICIANS IN PRIVATE PRACTICE CONTINUE TO CHOOSE LUCILE SALTER PACKARD CHILDRENS HOSPITAL AT STANFORD TO DELIVER THEIR PATIENTS. THE JOHNSON CENTERS 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-DEVELOPMENTAL 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, INCLUDING REDWOOD CITY, MOUNTAIN VIEW, FREMONT, SALINAS AND SANTA CRUZ. ADDITIONALLY, THE FERTILITY AND REPRODUCTIVE HEALTH SERVICES WERE ADDED TO THE JOHNSON CENTER IN FY15. 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 4,869 IN FISCAL YEAR 2016 COMPARED TO THE PRIOR YEAR DISCHARGES OF 4,743. IN 2016, 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 86% OF DISCHARGES. TWELVE PERCENT OF PATIENTS CAME FROM BAY AREA COUNTIES AND 2% FROM THE REMAINING CALIFORNIA COUNTIES AND OUT OF STATE. NEONATOLOGY SERVED A TOTAL OF 1,510 INPATIENTS IN FISCAL YEAR 2016 WITH AN AVERAGE LENGTH OF STAY OF 12.8 DAYS. OF THESE INPATIENTS, 68% WERE FROM THE PRIMARY SERVICE AREA, WITH 27% COMING FROM BAY AREA COUNTIES AND 5% FROM OUTSIDE THE BAY AREA. FORM 990, PART III, LINE 4B PROGRAM SERVICE DESCRIPTION CHILDREN'S HEART CENTER EXPENSE $314,534,000 GRANTS $0 REVENUE $326,529,000 THE HEART CENTERS 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 HEART CENTER CARES FOR CHILDREN REQUIRING SPECIALIZED CARDIOTHORACIC SERVICES ON A NATIONAL AND INTERNATIONAL BASIS, DRAWING PATIENTS FROM ALL OVER CALIFORNIA, AT LEAST 28 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 HEART CENTER FOR FETAL AND MATERNAL HEALTH. IN 2016, OUR VENTRICULAR ASSIST DEVICE PROGRAM CONTINUED TO GROW TO CARE FOR THE SICKEST OF CHILDREN WITH ADVANCED HEART FAILURE, AND WE IMPLANTED 38 ASSIST DEVICES OVER THE PAST THREE YEARS. IN ADDITION, 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 WAS 1,022 IN FISCAL YEAR 2016. OF THESE, THERE WERE 565 CARDIAC SURGERIES AND 17 HEART TRANSPLANTS. THE INPATIENT PROGRAM HAD A CASE MIX INDEX OF 4.5, REFLECTING THE HIGHLY COMPLEX POPULATION THAT WE SERVE. TWENTY-FIVE PERCENT OF PATIENTS CAME FROM OUR PRIMARY SERVICE AREA OF SAN MATEO AND SANTA CLARA COUNTIES, 32% CAME FROM BAY AREA COUNTIES, 28% CAME FROM OTHER AREAS WITHIN CALIFORNIA, AND 15% FROM OTHER STATES IN FISCAL YEAR 2016. FORM 990, PART III, LINE 4C PROGRAM SERVICE DESCRIPTION CANCER CENTER OF EXCELLENCE EXPENSE $123,847,000 GRANTS $0 REVENUE $128,570,000 THE CANCER 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 CANCER CENTER ALSO HAS EIGHT BEDS ALLOCATED TO THE PROGRAM TO SUPPORT CHEMOTHERAPY INPATIENT INFUSIONS AT THE LPCH-LICENSED INPATIENT UNIT AT EL CAMINO HOSPITAL IN MOUNTAIN VIEW, CALIFORNIA. THE CANCER 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 240 NEW CANCER PATIENTS PER YEAR AND PERFORMED 41 STEM CELL TRANSPLANTS IN FISCAL YEAR 2016. THE CANCER CENTER GOAL IS TO OFFER A COMPREHENSIVE PROGRAM THAT WILL SERVE MORE PATIENTS, TO DEVELOP A MORE ROBUST RESEARCH PLATFORM, AND TO EXPAND THE CANCER CENTERS GEOGRAPHIC REACH TO PROVIDE MORE CHILDREN WITH ACCESS TO THE SPECIALIZED SERVICES OFFERED BY THE CANCER CENTER. INPATIENT DISCHARGES FOR HEMATOLOGY/ONCOLOGY AND STEM CELL TRANSPLANT IN FISCAL YEAR 2016 TOTALED 1,242 WITH AN AVERAGE LENGTH OF STAY OF 8.1 DAYS. THE CANCER CENTER IS A STRONG REGIONAL PROGRAM WITH 53% OF PATIENTS COMING FROM THE PRIMARY SERVICE AREA OF SAN MATEO AND SANTA CLARA COUNTIES, 30% FROM THE SURROUNDING BAY AREA COUNTIES, 15% FROM OTHER CALIFORNIA COUNTIES AND 2% FROM OUTSIDE THE STATE OF CALIFORNIA.
FORM 990, PART III, LINE 4D	PROGRAM SERVICE DESCRIPTION OTHER PROGRAMS EXPENSE $333,499,322 GRANTS $1,126,253 REVENUE $435,790,895 IN ADDITION TO THE THREE PROGRAMS DESCRIBED ABOVE, LPCH PROVIDES CLINICAL SERVICES THROUGH THREE ADDITIONAL CENTERS OF EXCELLENCE: -CENTER FOR CHILDRENS 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 CHILDRENS BRAIN AND BEHAVIOR 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 HOSPITALS 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 2014, THE CHILDRENS BRAIN AND BEHAVIOR CENTER CONTINUED TO EXPAND SERVICES FOR CHILDREN WITH COMPLEX NEUROLOGICAL DISEASES SUCH AS NEUROMUSCULAR DISEASE, MOVEMENT DISORDERS, STROKE AND EPILEPSY. IN ALL OF THE BRAIN AND BEHAVIOR CENTERS 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 PACKARD CHILDRENS 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 CYSTIC FIBROSIS AND PULMONARY DISEASES 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 CYSTIC FIBROSIS AND PULMONARY DISEASES 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 HOSPITALS MISSION AND INTEGRAL TO THE HOSPITALS CLINICAL OPERATIONS. THE HOSPITAL IS COMMITTED TO SUPPORTING AND FUNDING QUALITY GRADUATE MEDICAL EDUCATION PROGRAMS AND EXCELLENCE IN RESIDENCY TRAINING AND RESEARCH. LPCHS CURRENTLY SPONSORS 26 RESIDENCY/FELLOWSHIP PROGRAMS APPROVED BY THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION AND OVER 200 ENROLLED RESIDENTS AND FELLOWS (STATED IN FULL TIME EQUIVALENTS). RESIDENCY PROGRAMS IN PHARMACY, SOCIAL WORK, HOSPITAL CHAPLAINCY, AND NURSING ARE ALSO PROVIDED. PACKARD CHILDRENS PARTNERS WITH STANFORD SCHOOL OF MEDICINE TO CONDUCT RESEARCH IN ALL SIX CENTERS OF EXCELLENCE DESCRIBED ABOVE. LUCILE SALTER PACKARD CHILDRENS HOSPITAL AT STANFORD 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, AS WELL AS SANTA CRUZ, MONTEREY, ALAMEDA, SAN FRANCISCO, AND CONTRA COSTA COUNTIES) TO ENHANCE ITS OWN AND THE COMMUNITYS CAPACITY TO CARE FOR CHILDREN AND PREGNANT WOMEN.THESE PROGRAMS INCLUDE: -MOBILE ADOLESCENT HEALTH SERVICES -CHILD SAFETY PROGRAMS -CARE-A-VAN FOR KIDS -COMMUNITY HEALTH EDUCATION PROGRAMS -SCHOOL-BASED HEALTH EDUCATION PROGRAMS -MENTAL HEALTH INNOVATION INITIATIVES -RESIDENT PHYSICIANS, FELLOWS, MEDICAL STUDENT EDUCATION COSTS (EXCLUDES FEDERAL CHILDRENS HOSPITALS GRADUATE MEDICAL EDUCATION [CHGME] REIMBURSEMENT) -NURSE AND ALLIED HEALTH PROFESSIONALS TRAINING -FUNDING FOR PEDIATRIC RESIDENT COMMUNITY PROJECTS -SUPPORT FOR PEDIATRIC WEIGHT CONTROL PROGRAM -SUBSIDIZED HEALTH SERVICES -SUPPORT FOR CHILDRENS HEALTH INSURANCE INITIATIVES -COMMUNITY BUILDING ACTIVITIES -ADVOCACY FOR CHILDRENS HEALTH ISSUES -COMMUNITY CLINIC CAPACITY BUILDING AND SUPPORT -EVENT SPONSORSHIP FOR NONPROFIT ORGANIZATIONS -COMMUNITY INVESTMENT GRANTS -PRACTICAL SUPPORT TO PATIENTS AND FAMILIES IN THE COUNTIES THAT COMPRISE THE HOSPITALS 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 HOSPITALS 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 OF WHICH, IN THE OPINION OF ANY FOUR (4) OF THE 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 (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 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 (UNTIL 1/3/16) WAS 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. JENNIFER JOHNSON AND MARIANN BYERWALTER HAD A BUSINESS RELATIONSHIP.
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 30,769,821 OTHER PURCHASED SERVICES 241,256,076 OTHER PROFESSIONAL SERVICE 406,739 OTHER MEDICAL SERVICES (MEDICAL GROUP) 164,018,024 TOTAL 436,450,660 RECONCILIATION FORM 990, PART XI, LINE 9 LOSS ON EXTINGUISHMENT OF LONG TERM DEBT (1,113,921) CHANGE IN VALUE OF BENEFICIAL INTEREST 1,418,798 IN REMAINDER TRUSTS ADJUSTMENT FOR MINIMUM PENSION 1,385,000 AND POST RETIREMENT LIABILITY TRANSFER TO STANFORD UNIVERSITY AND OTHER (26,861,429) TRANSFER OF NET INVESTMENT LOSS (34,580) ON CERTAIN ENDOWMENTS _______________ (25,206,132)

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

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

2015

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	SUPPRT SHC-VC	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 7999 GATEWAY BLVD STE 300 NEWARK,CA94560 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 1221 BROADWAY 3RD FLOOR OAKLAND,CA94612 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) 2015

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) ADOM PARTNERS LP 500 MADISON AVENUE NEW YORK,NY10022	INVESTMENTS	DE	NA
(2) ALBUS SELECT FUND LP 750 MENLO AVENUE MENLO PARK,CA94025	INVESTMENTS	DE	NA
(3) ARCOLA RESIDENTIAL VENTURE LLC 635 KNIGHT WAY STANFORD,CA943057297 90-0818278	REAL ESTATE	DE	NA
(4) ARCOLA VENTURE LLC 635 KNIGHT WAY STANFORD,CA943057297 37-1689632	RE DEVELOPMENT	DE	NA
(5) ATWATER 12 LP 2100 ROSS AVE STE 1600 DALLAS,TX75201 75-2944481	INVESTMENTS	DE	NA
(6) AVALANCHE ROYALTY PARTNERS LLC 410 17TH ST STE 1150 DENVER,CO80202 84-1539807	INVESTMENTS	DE	NA
(7) CEE EQUITY HOLDINGS LP ELIZABETH HOUSE 9 CASTLE ST ST. HELIER,,JERSEYJE4 2QP JE	INVESTMENTS	JE	NA
(8) CLAIRVUE CAPITAL PARTNERS II-TE 1 LP 150 CALIFORNIA STREET STE 850 SAN FRANCISCO,CA94111 80-0909516	INVESTMENTS	DE	NA
(9) CLAIRVUE CAPITAL PARTNERS II-TE 2 LP 150 CALIFORNIA STREET STE 850 SAN FRANCISCO,CA94111 80-0909556	INVESTMENTS	DE	NA
(10) CANARY SC FUND LP 399 PARK AVENUE NEW YORK,NY10022	INVESTMENTS	DE	NA
(11) ENERGY CAPITAL PARTNERS III (SENDERO CO- 51 JOHN F KENNEDY PARKWAY SUITE 2 SHORT HILLS,NJ07078 47-1702425	INVESTMENTS	DE	NA
(12) FORTRESS IW COINVESTMENT (FUND B) LP 1345 AVE OF THE AMERICAS 45TH FL NEW YORK,NY10105 98-0509639	INVESTMENTS	CJ	NA
(13) KEB INVESTORS II LP WASHINGTON MALL STE 304 7 REID ST HAMILTON,,HM 11 BD	INVESTMENTS	BD	NA
(14) LSF V DHB HOLDINGS LP 2711 N HASKELL AVE STE 1700 DALLAS,TX75204 27-2858604	INVESTMENTS	DE	NA
(15) OUTLAWS CASINO LTD 3160 PORTER DR PALO ALTO,CA94304 84-1457498	HOLDING COMPANY	CO	NA
(16) PALO ALTO LP 13 CASTLE STREET ST. HELIER, JERSEY JE 98-1126622	INVESTMENTS	JE	NA
(17) PROJECT EDISON PARTNERS FUND LP 55 E 52ND ST NEW YORK,NY10055 47-3184706	INVESTMENTS	DE	NA
(18) RESERVOIR RESOURCE PTRS TE LP 767 FIFTH AVE 16TH FLOOR NEW YORK,NY10153 46-2286221	INVESTMENTS	DE	NA
(19) RMS FOREST GROWTH II LP 30 INVERNESS CENTER PARKWAY STE 36 BIRMINGHAM,AL35242 20-0841908	INVESTMENTS	CA	NA
(20) SANDPIPER FUND LP 2000 MCKINNEY AVE STE 2125 DALLAS,TX75201 26-0341626	INVESTMENT	TX	NA
(21) SAROFIM MULTIFAMILY PARTNERS LP 8115 PRESTON RD ST400 DALLAS,TX75225 20-1929002	RE DEVELOPMENT	TX	NA
(22) SCP REAL ASSETS FUND (A) LP 2498 SAND HILL RD MENLO PARK,CA94025 20-3949682	INVESTMENTS	DE	NA
(23) SEQUOIA MFM OPERATING COMPANY LLC 770 WELCH ROAD LPCH- ADMIN MC5551 PALO ALTO,CA94304 47-5060529	MFM PROGRAM	CA	LPCH	RELATED	1,292,357	5,645,768		No	0		No	95.000 %
(24) SIC SNOWCREEK VIII LLC 635 KNIGHT WAY STANFORD,CA94305 27-5431605	RE DEVELOPMENT	CA	NA
(25) SP SMC PARTNERS LLC 2711 CENTERVILLE RD STE 400 WILMINGTON,DE19808 47-3103791	INVESTMENTS	DE	NA
(26) STANFORD EMANUEL RAD ONCOLOGY CENTER 825 DELBON AV TURLOCK,CA95382 20-8885091	RADIOLOGY	CA	NA
(27) STANFORD PET-CT LLC 300 PASTEUR DR MC 5555 STANFORD,CA94305 61-1423414	MED. DIAGNOST	CA	NA
(28) STANFORD-STARTX FUND LLC 3145 PORTER DR PALO ALTO,CA94304 46-4297719	INVESTMENTS	DE	NA
(29) SUMIT HOLDING INTERNATIONAL LLC 1400 PAGE MILL ROAD MC5713 PALO ALTO,CA94304 26-3934706	HOLDING COMPANY	DE	NA	RELATED	-567,446	16,211,291		No	0		No	18.000 %
(30) VEDA INVESTORS FUND LP ONE FAWCETT PL GREENWICH,CT06830	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) EAST SAIL C/O INTL FS INC IFS COURT TWENTYEIGHT, CYBERCITY, EBENE MP	INVESTMENTS	MP	NA	C CORP
(3) GAVEA INVESTMENT FUND II-C LP PO BOX 896GT HARBOUR CENTRE GEORGE TOWN,CAYMAN ISLANDS CJ 98-0537952	INVESTMENTS	CJ	NA	C CORP
(4) LS ALBERTA III LP C/O JE ROBERT COS 1650 TYSON BLVD MCLEAN,VA22102 98-0493425	INVESTMENTS	CA	NA	C CORP
(5) CLAT (16)	CHARITABLE TR	CA	NA	TRUST
(6) CRT (555)	CHARITABLE TR	CA	NA	TRUST
(7) OTHER (7)	CHARITABLE TR	CA	NA	TRUST
(8) PIF (2)	CHARITABLE TR	CA	NA	TRUST
(9) ALPINE CHALET INC PO BOX 9988 SOUTH LAKE TAHOE,CA96158 94-1556099	SKI LODGE	CA	NA	C CORP
(10) STANFORD (BEIJING) CNSLTNG CO LTD (WFOE) 5275TH FLBLDG CACADEMY SOUTH RD HAIDAN DISTRICT,BEIJING CH	EDUCATION	CH	NA	C CORP
(11) STANFORD UNIV MED NETWORK RISK AUTHORITY 1400 PAGE MILL RD MSC 5713 PALO ALTO,CA94304 46-1132002	RISK MGMT CON	CA	NA	C CORP	-58,581	-58,581	18.000 %	Yes
(12) PROFESSIONAL EXCHANGE ASSURANCE COMPANY 201 MERCHANT STREET SUITE 2400 HONOLULU,HI96813 90-0897686	INSURANCE	HI	NA	C CORP
(13) ARCOLA RES DEVELOPMENT CORP C/O SMC 635 KNIGHT WAY STANFORD,CA943057297 80-0804754	INVESTMENTS	DE	NA	C CORP
(14) BREP VII ALBERTA FEEDER(OFFSHORE)TE7 LP C/O THE BLACKSTONE GROUP 345 PARK NEW YORK,NY10154 98-1066351	INVESTMENTS	CA	NA	C CORP
(15) BREP VII ALBERTA FEEDER(OFFSHORE)TE7NQLP C/O THE BLACKSTONE GROUP 345 PARK NEW YORK,NY10154 98-1066355	INVESTMENTS	CA	NA	C CORP
(16) WEST FACE ALTERNATIVE CREDIT CAYMAN LP PO BOX 10008 WILLOW HOUSE GRAND CAYMAN,CAYMAN ISLANDSKY1-1001 CJ 98-1140761	INVESTMENTS	CJ	NA	C CORP
(17) MIDPOINT TECHNOLOGY PARK OWNERS ASSOC 3145 PORTER DRIVE PALO ALTO,CA94304 94-3287254	REAL ESTATE	CA	NA	C CORP
(18) BIENVILLE ARGENTINA OPPS OFFSHORE FUND 405 LEXINGTON AVE 34TH FLOOR NEW YORK,NY10174	INVESTMENTS	CJ	NA	C CORP
(19) KAIZEN FUND 1 NORTH BRIDGE RD 6-8 SINGAPORE,SINGAPORE179094 SN	INVESTMENTS	CJ	NA	C CORP
(20) AFFINITY MEDICAL SOLUTIONS INC 1221 BROADWAY 3RD FLOOR OAKLAND,CA94612 20-3134011	HEALTHCARE	DE	NA	C CORP
(21) BISHOP ROCK OPPORTUNITY OFFSHORE FUND C/O SMC 635 KNIGHT WAY STANFORD,CA94305	INVESTMENTS	CJ	NA	C CORP
(22) SBFF LTD PO BOX 1344 GEORGE TOWN CJ	INVESTMENTS	CJ	NA	C CORP
(23) CANARY SC FUND LTD 399 PARK AVE NEW YORK,NY10022	INVESTMENTS	CJ	NA	C CORP
(24) THE RUBRUM FUND PO BOX 309 UGLAND HOUSE GRAND CAYMAN,CAYMAN ISLANDS CJ	INVESTMENTS	CJ	NA	C CORP
(25) SEA SMOKE FUND LLC 190 ELGIN AVENUE GEORGE TOWN,GRAND CAYMANKY 9005 CJ	INVESTMENTS	CJ	NA	C CORP
(26) STANFORD MEDICINE INTL (HONG KONG) CO LT 833 CHEUNG SHA WAN ROAD KOWLOON,HONG KONG HK	PATIENT SRVC	HK	NA	C CORP
(27) STANFORD INTL MEDICAL SERVICES RAK FZE PO BOX 56500 AE	PATIENT SRVC	AE	NA	C CORP
(28) STANFORD IN JAPAN GODO KAISHA DOSHISHA UNIVERSITY MEITOKUKAN-NAI KAMIGYO-KU,KYOTO-SHI JA	EDUCATION	JA	NA	C CORP

Schedule R (Form 990) 2015

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)	L,M	80,186,216	FMV
(2) STANFORD HOSPITAL AND CLINICS (SHC)	N	30,416,403	FMV
(3) STANFORD HOSPITAL AND CLINICS (SHC)	O	3,107,531	FMV
(4) STANFORD HOSPITAL AND CLINICS (SHC)	P,Q	959,190	FMV
(5) STANFORD HOSPITAL AND CLINICS (SHC)	R	3,300,000	FMV
(6) OTHER TRUST	C	664,485	FMV

Schedule R (Form 990) 2015

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) 2015

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 5	CHARITABLE LEAD ANNUITY TRUSTS ARE PRINCIPALLY DOMICILED IN CALIFORNIA.
SCHEDULE R, PART IV, LINE 6	CHARITABLE REMAINDER TRUSTS ARE PRINCIPALLY DOMICILED IN CALIFORNIA.
SCHEDULE R, PART IV, LINE 7	OTHER TRUSTS ARE PRINCIPALLY DOMICILIED IN CALIFORNIA.
SCHEDULE R, PART IV, LINE 1	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.

Schedule R (Form 990) 2015

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	32
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 2015 (Part V, line 2a) ......	5	4,070
6	Total number of volunteers (estimate if necessary) .............	6	825
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) .........	71,660,572	144,563,058
9	Program service revenue (Part VIII, line 2g) .........	1,284,282,316	1,281,784,895
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	43,482,771	111,903,870
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	-5,263,457	-6,410,237
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	1,394,162,202	1,531,841,586
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	919,275	1,126,253
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)	482,334,877	530,036,562
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 11,146,828
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	714,107,849	736,920,741
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,197,362,001	1,268,083,556
19	Revenue less expenses. Subtract line 18 from line 12.......	196,800,201	263,758,030
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	2,811,287,000	3,084,796,878
21	Total liabilities (Part X, line 26).............	811,462,680	936,911,027
22	Net assets or fund balances. Subtract line 21 from line 20.....	1,999,824,320	2,147,885,851

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 376,535,000 including grants of $ ) (Revenue $ 390,895,000 )
	SEE SCHEDULE O

4b	(Code: ) (Expenses $ 314,534,000 including grants of $ ) (Revenue $ 326,529,000 )
	SEE SCHEDULE O

4c	(Code: ) (Expenses $ 123,847,000 including grants of $ ) (Revenue $ 128,570,000 )
	SEE SCHEDULE O

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 333,499,322 including grants of $ 1,126,253 ) (Revenue $ 435,790,895 )
4e	Total program service expenses1,148,415,322

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	8,549,124	9,663,076	2,432,081

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 above		1f	144,563,058

g	Noncash contributions included in lines 1a-1f:$
h Total.Add lines 1a-1f.......		144,563,058

		Business Code
2a	PATIENT SERVICE	900099	978,548,331	978,548,331
b	GOVERNMENT FUND	900099	7,063,691	7,063,691
c	MEDICARE/MEDICAID	900099	208,920,016	208,920,016
d	PROVIDER FEE	900099	51,793,240	51,793,240
e	REVENUE FROM HEALTH RELATED ACTIVITIES	900099	20,194,579	20,194,579
f	All other program service revenue.			15,265,038	15,265,038
g Total.Add lines 2a–2f.....			1,281,784,895

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			111,772,118			111,772,118
4 Income from investment of tax-exempt bond proceeds			131,752			131,752
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents	1,940,217
b	Less: rental expenses	2,392,096
c	Rental income or (loss)	-451,879	0
d	Net rental income or (loss)......			-451,879			-451,879
		(ii) Other	(i) Securities
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
Business Code			Miscellaneous Revenue
11a	CAFETERIA		900099	2,453,949			2,453,949
b	INVESTMENT INCOME FROM RELATED PROGRAM		900099	-12,766,466			-12,766,466
c	OTHER		900099	4,354,159			4,354,159
d	All other revenue ....
e	Total. Add lines 11a–11d ......			-5,958,358
12	Total revenue. See Instructions......			1,531,841,586	1,281,784,895		105,493,633

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	1,126,253	1,126,253
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	0
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	0
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	4,738,411	2,460,599	1,999,155	278,657
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	261,549		261,549
7	Other salaries and wages	347,355,627	323,675,524	23,680,103
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	29,161,827	27,016,641	2,145,186
9	Other employee benefits .......	121,057,584	112,021,472	9,036,112
10	Payroll taxes ...........	27,461,564	25,538,074	1,923,490
11	Fees for services (non-employees):
a	Management ......	13,411,473	7,382,089	6,029,384
b	Legal .........	3,169,207		3,169,207
c	Accounting ...........	529,808	58,697	471,111
d	Lobbying ...........	69,500	69,500
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)	436,450,660	409,718,916	26,731,744
12	Advertising and promotion ....	7,252,134	7,251,386	748
13	Office expenses .......	121,881,977	119,047,135	2,834,842
14	Information technology ......	15,751,644	15,718,464	33,180
15	Royalties ..	0
16	Occupancy ...........	21,416,336	13,633,472	7,782,864
17	Travel ............	1,133,921	835,768	298,153
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	0
20	Interest ...........	9,512,134	9,512,134
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	52,231,731	37,961,045	14,270,686
23	Insurance ...	5,844,327	3,061,252	2,783,075
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	24,195,931	24,195,931
b	UTILITIES	4,871,899	4,246,097	625,802
c	LICENSES & TAXES	4,162,722	3,878,864	283,858
d	OTHER EXPENSES	15,035,337	6,009	4,161,157	10,868,171
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	1,268,083,556	1,148,415,322	108,521,406	11,146,828
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).

1	Cash–non-interest-bearing ........			1,895	1	1,895
2	Savings and temporary cash investments .........			335,075,518	2	532,326,424
3	Pledges and grants receivable, net ......			30,543,839	3	115,651,397
4	Accounts receivable, net .............			291,804,875	4	295,185,788
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 ........			7,178,752	8	7,844,141
9	Prepaid expenses and deferred charges ......			7,980,163	9	9,117,304
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,834,120,744
b	Less: accumulated depreciation	10b	414,916,277	1,072,135,401	10c	1,419,204,467
11	Investments—publicly traded securities .			69,312,835	11	70,641,624
12	Investments—other securities. See Part IV, line 11 .....			967,155,380	12	608,583,734
13	Investments—program-related. See Part IV, line 11 ..			3,399,006	13	-17,185,028
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			26,699,336	15	43,425,132
16	Total assets. Add lines 1 through 15 (must equal line 34)...			2,811,287,000	16	3,084,796,878

17	Accounts payable and accrued expenses .....	167,090,779	17	207,848,840
18	Grants payable ...	0	18	0
19	Deferred revenue .........	0	19	0
20	Tax-exempt bond liabilities .........	559,686,467	20	668,405,743
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	84,685,434	25	60,656,444
26	Total liabilities. Add lines 17 through 25..	811,462,680	26	936,911,027

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	1,337,179,747	27	1,362,418,361
28	Temporarily restricted net assets ...........	458,239,166	28	574,119,254
29	Permanently restricted net assets	204,405,407	29	211,348,236
	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 ...........	1,999,824,320	33	2,147,885,851
34	Total liabilities and net assets/fund balances ........	2,811,287,000	34	3,084,796,878