TY 2017 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) JEFF CHAMBERS...................................................................... CHAIR	20.0 ................. 2.0	X	X	0	1,863	0
(2) MARIANN BYERWALTER...................................................................... VICE CHAIR	4.0 ................. 2.0	X	X	0	0	0
(3) SUSAN ORR...................................................................... VICE CHAIR (UNTIL 12/2017)	4.0 ................. 0.0	X	X	0	0	0
(4) CHRISTOPHER DAWES...................................................................... PRESIDENT/CEO (UNTIL 3/2018)	50.0 ................. 2.0	X	X	3,707,335	0	1,284,357
(5) DENNIS P LUND MD...................................................................... DIRECTOR/CMO	50.0 ................. 3.0	X	X	0	904,008	54,644
(6) DAVID ALEXANDER MD...................................................................... DIRECTOR (Until 3/2018)	4.0 ................. 40.0	X		0	926,300	66,986
(7) SUE BOSTROM...................................................................... DIRECTOR	4.0 ................. 0.0	X		0	0	0
(8) ELAINE CHAMBERS...................................................................... DIRECTOR	4.0 ................. 0.0	X		0	0	0
(9) SIERRA CLARK...................................................................... DIRECTOR (AS OF 1/2018)	4.0 ................. 0.0	X		0	0	0
(10) CHRISTIE COLEMAN...................................................................... DIRECTOR	4.0 ................. 0.0	X		0	0	0
(11) JONATHAN COSLET...................................................................... DIRECTOR (Until 12/2017)	4.0 ................. 0.0	X		0	0	0
(12) J TAYLOR CRANDALL...................................................................... DIRECTOR	4.0 ................. 0.0	X		0	0	0
(13) WILLIAM CROWN...................................................................... DIRECTOR	4.0 ................. 0.0	X		0	0	0
(14) SUSAN FORD-DORSEY...................................................................... DIRECTOR	4.0 ................. 0.0	X		0	0	0
(15) DAVID ENTWISTLE...................................................................... DIRECTOR	4.0 ................. 53.25	X		0	2,423,244	357,563
(16) JAMES DUNN...................................................................... DIRECTOR	4.0 ................. 50.0	X		0	1,096,221	48,468
(17) JENNIFER JOHNSON...................................................................... DIRECTOR	4.0 ................. 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) TONIA KARR........................................................................ DIRECTOR (AS OF 11/2017)	4.0 .......................2.0	X				0	0	0
(19) FRANK LEE........................................................................ DIRECTOR	4.0 .......................2.0	X				0	0	0
(20) MARY LEONARD MD........................................................................ DIRECTOR	4.0 .......................50.0	X				0	754,593	21,543
(21) JOHN LEVIN........................................................................ DIRECTOR	4.0 .......................2.0	X				0	0	0
(22) JOHN LILLIE........................................................................ DIRECTOR	4.0 .......................0.0	X				0	0	0
(23) ANN LIVERMORE........................................................................ DIRECTOR	4.0 .......................0.0	X				0	0	0
(24) RANDY LIVINGSTON........................................................................ DIRECTOR (AS OF 10/17)	4.0 .......................52.0	X				0	687,844	281,215
(25) STEVE LUCZO........................................................................ DIRECTOR (AS OF 7/2018)	4.0 .......................0.0	X				0	0	0
(26) MARISSA MAYER........................................................................ DIRECTOR (AS OF 4/2018)	4.0 .......................0.0	X				0	0	0
(27) LLOYD B MINOR MD........................................................................ DIRECTOR	4.0 .......................54.0	X				0	3,643,020	163,818
(28) BRIAN PERRONNE........................................................................ DIRECTOR (AS OF 3/2018)	4.0 .......................40.0	X				0	513,692	106,576
(29) CHRISTY SANDBORG MD........................................................................ DIRECTOR	4.0 .......................50.0	X				0	478,066	46,754
(30) MINDY ROGERS........................................................................ DIRECTOR	4.0 .......................2.0	X				0	0	0
(31) JANE SHAW........................................................................ DIRECTOR	4.0 .......................0.0	X				0	0	0
(32) AMIT SINHA........................................................................ DIRECTOR	4.0 .......................0.0	X				0	0	0
(33) WILLIAM THOMPSON III........................................................................ DIRECTOR	4.0 .......................0.0	X				0	0	0
(34) JORGE TITINGER........................................................................ DIRECTOR	4.0 .......................0.0	X				0	0	0
(35) JOHN WALKER........................................................................ DIRECTOR	4.0 .......................1.0	X				0	0	0
(36) VAUGHN WILLIAMS........................................................................ DIRECTOR	4.0 .......................2.0	X				0	0	0
(37) JAMES WOODY........................................................................ DIRECTOR	4.0 .......................0.0	X				0	0	0
(38) ANNE MCCUNE........................................................................ CHIEF OPERATING OFFICER	50.0 .......................0.0		X			696,175	0	33,040
(39) DANA HAERING........................................................................ VP & CFO	47.0 .......................3.0		X			622,015	0	104,066
(40) CAMERON D'ALPE........................................................................ CAO PHYSICIAN PRAC & CEO PCHA	33.0 .......................17.0			X		405,274	0	87,947
(41) KELLY JOHNSON........................................................................ VP PATIENT CARE SERVICES & CNO	50.0 .......................0.0			X		637,827	0	125,824
(42) EDWARD KOPETSKY........................................................................ VP & CIO	50.0 .......................1.0			X		598,740	0	80,796
(43) KRISTIN PETERSEN........................................................................ VP PROCED & DIAGNOSTIC SERVICE	50.0 .......................0.0			X		419,773	0	120,159
(44) KIM ROBERTS........................................................................ CHIEF STRATEGY OFFICER	33.0 .......................17.0			X		754,741	0	67,925
(45) HELEN WILMOT........................................................................ SHC ADMIN - COO	25.0 .......................25.0			X		0	446,164	52,443
(46) MARK TORTORICH........................................................................ VP DESG,PLAN,CONST(UNTIL 2/17)	25.0 .......................25.0			X		0	470,314	17,948
(47) MICHAEL LANE........................................................................ VP LPCH CONSTRUCTION	50.0 .......................0.0				X	557,711	0	121,097
(48) ROBERT POOLE........................................................................ PHARMACY	50.0 .......................0.0				X	501,324	0	0
(49) GREGORY J SOUZA........................................................................ CHRO	50.0 .......................0.0				X	504,595	0	60,287
(50) ROSALINDA LUNA........................................................................ CLINICAL NURSE IV	50.0 .......................0.0				X	464,375	0	63,792
(51) LISA GRISIM........................................................................ VP & ASSOCIATE CIO	50.0 .......................0.0				X	435,516	0	104,846

(A) Name and business address	(B) Description of services	(C) Compensation
DPR CONSTRUCTION INC, 1450 VETERANS BLVD REDWOOD CITY,CA94063	CONSTRUCTION	217,744,003
STANFORD UNIVERSITY, 450 SERRA MALL PALO ALTO,CA94305	PURCHASED SERVICES	126,473,579
STANFORD HOSPITAL CLINICS, 300 PASTEUR DR STANFORD,CA94305	MEDICAL LABORATORY	122,433,860
FIRST AMERICAN TITLE, 2755 CAMPUS DRIVE SUITE 125 SAN MATEO,CA94403	PURCH SVCS/SUPPLIES	32,950,000
MCKESSON HEALTH SOLUTIONS, 12748 COLLECTION CENTER DRIVE CHICAGO,IL60693	MEDICAL SUPPLIES	28,570,002
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 448

- 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.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

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 12, 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 agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

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 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

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) 2019

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 failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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 2019 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2018 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2019. 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—2018. 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—2019. 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—2018. 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) 2019

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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 2019 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2018 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2019 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2018 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2019. 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—2018. 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) 2019

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d 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 12a or 12b 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) 2019

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) 2019

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 (explain in Part VI). 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) 2019

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 2019 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-2019	(iii) Distributable Amount for 2019
1 Distributable amount for 2019 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2019:
a From 2014.......
b From 2015.......
c From 2016.......
d From 2017.......
e From 2018.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2019 distributable amount
i Carryover from 2014 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2019 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2019 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2020. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2015.....
b Excess from 2016.....
c Excess from 2017.....
d Excess from 2018.....
e Excess from 2019.....

Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019

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) 2019

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.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

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. Don't 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 isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2

Name of organization LUCILE SALTER PACKARD CHILDREN'S HOSPITAL AT STANFORD

Part I Contributors	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
		$	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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

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) (2019)

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

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 (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

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) 2019

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) 2016	(b) 2017	(c) 2018	(d) 2019	(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) 2019

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|No

(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? ..........................................................

Yes

209,652

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

Yes

176,823

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

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

Yes

1,732,864

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

2,119,339

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 OF THE INTERACTION IS RELATIONSHIP BUILDING MAINTAINING AS WELL AS WORKING ON COLLABORATIVE PROGRAMS AND PROJECTS TO ENHANCE THE OVERALL HEALTH OF THE COMMUNITY. IN FY18, ROUGHLY 20% OF THE CHIEF GOVERNMENT RELATIONS OFFICER, THE GOVERNMENT RELATIONS MANAGER AND THE SENIOR POLICY MANAGER'S TIME WAS SPENT ON LOBBYING ON SPECIFIC LEGISLATIVE ISSUES - VALUE APPROXIMATELY $138,324 (INCLUDES DOLLARS ALLOTTED FOR BENEFITS). IN ADDITION, IN FY18, 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 SPENT ON EFFORTS TO INFLUENCE LEGISLATIVE MATTERS IN THE HEALTH CARE INDUSTRY. DURING FY18, THE APPROXIMATE AMOUNT OF DUES SPENT ON LOBBYING PURPOSES WAS $191,464 AND THE APPROXIMATE AMOUNT SPENT ON TRAVEL EXPENSES WAS $18,188. LUCILE SALTER PACKARD CHILDREN'S HOSPITAL (LPCH) MADE CONTRIBUTIONS IN SUPPORT OF TWO BALLOT MEASURES DURING FISCAL YEAR 2018: IN JULY 2018, LPCH MADE A CONTRIBUTION TO THE "YES ON PROPOSITION 4 CAMPAIGN", SPONSORED BY THE CALIFORNIA CHILDREN'S HOSPITAL ASSOCIATION. THE BALLOT MEASURE AUTHORIZES $1.5 BILLION IN BONDS, TO FUND GRANTS FOR THE CONSTRUCTION, EXPANSION, RENOVATION AND EQUIPMENT PROJECTS OF QUALIFYING CHILDREN'S HOSPITALS. SUPPORT WAS IN THE FORM OF A MONETARY CONTRIBUTION AND LPCH PERSONNEL ENGAGING WITH ELECTED OFFICIALS AND OTHER INTERESTED PARTIES. IN AUGUST 2018, LPCH MADE A CONTRIBUTION TO THE "YES ON MEASURE W" CAMPAIGN, SPONSORED BY THE SAN MATEO COUNTY NEIGHBORS RELIEF COMMITTEE. THE BALLOT MEASURE RAISES APPROXIMATELY $2.4 BILLION THROUGH A CENT SALES TAX TO FUND A VARIETY OF TRANSPORTATION PROJECTS IN SAN MATEO COUNTY, INCLUDING THE OPERATIONS AND CAPITAL INVESTMENT FOR BUS, PARATRANSIT SERVICE, AND CALTRAIN. THE MEASURE ALSO INCLUDES FUNDS TO CREATE SAFE PLACES FOR WALKING AND BIKING, ALONG WITH INVESTMENTS IN LOCAL ROADS AND HIGHWAYS. SUPPORT WAS IN THE FORM OF A MONETARY CONTRIBUTION AND LPCH PERSONNEL ENGAGING WITH ELECTED OFFICIALS, COMMUNITY LEADERS, SAN MATEO RESIDENTS AND OTHER INTERESTED PARTIES.

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 OF THE INTERACTION IS RELATIONSHIP BUILDING MAINTAINING AS WELL AS WORKING ON COLLABORATIVE PROGRAMS AND PROJECTS TO ENHANCE THE OVERALL HEALTH OF THE COMMUNITY. IN FY18, ROUGHLY 20% OF THE CHIEF GOVERNMENT RELATIONS OFFICER, THE GOVERNMENT RELATIONS MANAGER AND THE SENIOR POLICY MANAGER'S TIME WAS SPENT ON LOBBYING ON SPECIFIC LEGISLATIVE ISSUES - VALUE APPROXIMATELY $138,324 (INCLUDES DOLLARS ALLOTTED FOR BENEFITS). IN ADDITION, IN FY18, 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 SPENT ON EFFORTS TO INFLUENCE LEGISLATIVE MATTERS IN THE HEALTH CARE INDUSTRY. DURING FY18, THE APPROXIMATE AMOUNT OF DUES SPENT ON LOBBYING PURPOSES WAS $191,464 AND THE APPROXIMATE AMOUNT SPENT ON TRAVEL EXPENSES WAS $18,188. LUCILE SALTER PACKARD CHILDREN'S HOSPITAL (LPCH) MADE CONTRIBUTIONS IN SUPPORT OF TWO BALLOT MEASURES DURING FISCAL YEAR 2018: IN JULY 2018, LPCH MADE A CONTRIBUTION TO THE "YES ON PROPOSITION 4 CAMPAIGN", SPONSORED BY THE CALIFORNIA CHILDREN'S HOSPITAL ASSOCIATION. THE BALLOT MEASURE AUTHORIZES $1.5 BILLION IN BONDS, TO FUND GRANTS FOR THE CONSTRUCTION, EXPANSION, RENOVATION AND EQUIPMENT PROJECTS OF QUALIFYING CHILDREN'S HOSPITALS. SUPPORT WAS IN THE FORM OF A MONETARY CONTRIBUTION AND LPCH PERSONNEL ENGAGING WITH ELECTED OFFICIALS AND OTHER INTERESTED PARTIES. IN AUGUST 2018, LPCH MADE A CONTRIBUTION TO THE "YES ON MEASURE W" CAMPAIGN, SPONSORED BY THE SAN MATEO COUNTY NEIGHBORS RELIEF COMMITTEE. THE BALLOT MEASURE RAISES APPROXIMATELY $2.4 BILLION THROUGH A CENT SALES TAX TO FUND A VARIETY OF TRANSPORTATION PROJECTS IN SAN MATEO COUNTY, INCLUDING THE OPERATIONS AND CAPITAL INVESTMENT FOR BUS, PARATRANSIT SERVICE, AND CALTRAIN. THE MEASURE ALSO INCLUDES FUNDS TO CREATE SAFE PLACES FOR WALKING AND BIKING, ALONG WITH INVESTMENTS IN LOCAL ROADS AND HIGHWAYS. SUPPORT WAS IN THE FORM OF A MONETARY CONTRIBUTION AND LPCH PERSONNEL ENGAGING WITH ELECTED OFFICIALS, COMMUNITY LEADERS, SAN MATEO RESIDENTS AND OTHER INTERESTED PARTIES.

Schedule C (Form 990 or 990EZ) 2019

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.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

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 7/25/06, 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 FASB 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 FASB 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 FASB 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) 2019

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 ....	339,282,000	306,284,000	307,571,000	308,872,000	280,799,140
b	Contributions ...	869,000	14,186,000	5,763,000	853,000	643,000
c	Net investment earnings, gains, and losses	29,245,000	35,765,000	8,643,000	12,649,000	42,123,000
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	16,022,000	16,953,000	15,693,000	14,803,000	14,693,140
f	Administrative expenses ....
g	End of year balance ......	353,374,000	339,282,000	306,284,000	307,571,000	308,872,000

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

Board designated or quasi-endowment SchDMd Bullet

0 %

Permanent endowment SchDMd Bullet

64.520 %

Term endowment SchDMd Bullet

35.480 %

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 ....	1,692,577,948	218,271,955	1,474,305,993
c	Leasehold improvements	38,216,833	27,104,519	11,112,314
d	Equipment ....	462,647,845	238,373,314	224,274,531
e	Other .....	202,736,421	52,284,722	150,451,699
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				1,884,377,037

Schedule D (Form 990) 2019

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	724,422,996	F
(B) ASSETS LIMITED AS TO USE, HELD	34	F
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	724,423,030

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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
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
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	54,945,213
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) 2019

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, PART X, LINE 2	FIN 48 LPCH IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF STANFORD UNIVERSITY, WHICH INCLUDE THE FOLLOWING NOTE: IN ACCORDANCE WITH THE GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, MANAGEMENT REGULARLY EVALUATES ITS TAX POSITIONS AND DOES NOT BELIEVE LPCH HAS ANY UNCERTAIN TAX POSITIONS THAT REQUIRE DISCLOSURE OR ADJUSTMENT TO THE FINANCIAL STATEMENTS.

Schedule D (Form 990) 2019

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

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2019

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) . . .		478	1,805,526		1,805,526	0.120 %
b	Medicaid (from Worksheet 3, column a) . . . . .		24,007	572,482,576	359,496,917	212,985,659	13.660 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .		24,485	574,288,102	359,496,917	214,791,185	13.780 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	18	40,685	3,684,478	241,344	3,443,134	0.220 %
f	Health professions education (from Worksheet 5) . . .	7	1,319	24,924,044	6,669,502	18,254,542	1.170 %
g	Subsidized health services (from Worksheet 6) . . . .	1		1,361,000		1,361,000	0.090 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	4	88,813	2,474,633		2,474,633	0.160 %
j	Total. Other Benefits . .	30	130,817	32,444,155	6,910,846	25,533,309	1.640 %
k	Total. Add lines 7d and 7j .	30	155,302	606,732,257	366,407,763	240,324,494	15.420 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019

Schedule H (Form 990) 2019

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development	1		92,070	92,070	0.010 %
3	Community support	2		2,883,414	2,883,414	0.180 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy	1		462,455	462,455	0.030 %
8	Workforce development	2	23	337,227	337,227	0.020 %
9	Other
10	Total	6	23	3,775,166	3,775,166	0.240 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare 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. ......

1,346,468

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

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

4,635,095

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

13,659,148

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

-9,024,053

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) 2019

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?1Name, 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) 2019

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

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

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): COMMUNITYBENEFITS.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 16

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

Yes

If "Yes" (list url): COMMUNITYBENEFITS.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) 2019

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)

Was widely publicized 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)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

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

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	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 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 nonpayment?..................................

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

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

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

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

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

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):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

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)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

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

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

Yes

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 a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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) 2019

Page 8

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, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 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	LUCILE SALTER PACKARD CHILDREN'S HOSPITAL AT STANFORD ("LPCH") VALUES AND PRIORITIZES INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY IN OUR COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS. IN TAX YEAR 2015, IN COLLABORATION WITH LOCAL AREA NONPROFIT HOSPITAL ORGANIZATIONS AND THE SAN MATEO AND SANTA CLARA COUNTY DEPARTMENTS OF PUBLIC HEALTH, LPCH CONDUCTED A CHNA WITH APPLIED SURVEY RESEARCH (ASR), A LOCAL NONPROFIT SOCIAL RESEARCH FIRM. THE PURPOSE OF THE CHNA 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 THE IMPLEMENTATION OF LPCH'S 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. FURTHERMORE, PUBLIC HEALTH OFFICIALS FROM BOTH COUNTIES WERE ACTIVE MEMBERS OF THE CHNA COLLABORATIVES. COUNTY PUBLIC HEALTH OFFICIALS WERE ALSO INCLUDED IN THE WIDER PRIMARY DATA COLLECTION. OUR NEXT CHNA IS CURRENTLY BEING CONDUCTED AND WILL BE POSTED BY AUGUST 31, 2019. PRIMARY QUALITATIVE DATA (COMMUNITY INPUT) IN COOPERATION WITH THE AFOREMENTIONED CHNA COLLABORATIVES IN OUR PRIMARY SERVICE AREA OF SAN MATEO AND SANTA CLARA COUNTIES, LPCH'S 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 COMMUNITY'S 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. THE FOCUS GROUPS WERE CONDUCTED IN MARCH OF 2015. ORGANIZATIONS CONSULTED: - ADOLESCENT COUNSELING SERVICES (YOUTH BEHAVIORAL HEALTH, 3/20/2015) - AMERICAN METHODIST EPISCOPAL ZION CHURCH (FAITH COMMUNITY, 3/30/2015) - CATHOLIC CHARITIES (MINORITY COMMUNITY - IMMIGRANTS, 6/4/2015) - COASTSIDE HOPE (MINORITY COMMUNITY - IMMIGRANTS & LOW-INCOME, 4/8/2015) - COMMUNITY GATEPATH (OLDER ADULTS, 3/11/15) - CONGREGATIONAL CHURCH OF SAN MATEO (UNDERSERVED, LOW-INCOME, 4/14/15) - DALY CITY YOUTH HEALTH CENTER (YOUTH, LOW-INCOME, 5/21/2015) - FIRST 5 (CHILDREN, 4/7/15) - HOME SAFETY SERVICES (OLDER ADULTS, 3/11/15) - INNVISION - SHELTER NETWORK (LOW-INCOME, 4/17/2015) - LESLEY SENIOR COMMUNITIES (OLDER ADULTS, 3/11/15) - LGBTQ COMMISSION (MINORITY COMMUNITY, 5/28/2015) - LINCOLN STREET CENTER (MINORITY, OLDER ADULTS, 3/17/15) - MIDPEN RESIDENT SERVICES CORP. (OLDER ADULTS, 3/11/15) - MILLS-PENINSULA HEALTH SERVICES AFRICAN AMERICAN COMMUNITY HEALTH ADVISORY COMMITTEE (MINORITY COMMUNITY, 3/10/15) - MULTICULTURAL INSTITUTE (MINORITY, 4/7/15) - PENINSULA FAMILY SERVICE (LOW-INCOME, MINORITY, 4/1/15) - PENINSULA VOLUNTEERS MEALS ON WHEELS (OLDER ADULTS, LOW-INCOME, 3/11/15) - PUENTE (LOW-INCOME, MINORITY, UNDERSERVED, 3/27/15) - RAVENSWOOD FAMILY HEALTH CENTER (LOW-INCOME & MINORITY COMMUNITY, 3/30/2015) - REDWOOD CITY FAIR OAKS COMMUNITY CENTER (LOW-INCOME, 5/21/2015) - REDWOOD CITY PARKS, RECREATION AND COMMUNITY SERVICES (OLDER ADULTS & YOUTH, 4/9/2015) - SAMARITAN HOUSE (LOW-INCOME, HOMELESS, 3/10/2015) - SAN MATEO COUNTY BOARD OF SUPERVISORS (4/7/2015) - SAN MATEO COUNTY HEALTH & HOSPITAL SYSTEM (MEDICAL UNDERSERVED, 4/16/2015) - SAN MATEO COUNTY HEALTH DEPARTMENT (PUBLIC HEALTH, 3/27/15) - SAN MATEO COUNTY HUMAN SERVICES AGENCY (UNDERSERVED POPULATIONS, 3/20/11) - SAN MATEO JAPANESE-AMERICAN COMMUNITY CENTER (MINORITY, OLDER ADULTS, 3/11/15) - SECOND HARVEST FOOD BANK (LOW-INCOME, 3/11/15) - SMC HEALTH SYSTEM (BHRS) (UNDERSERVED, 3/26/15) - SMC HEALTH SYSTEM; AGING AND ADULT SERVICES (OLDER ADULTS, 4/8/15) - SOUTH SAN FRANCISCO PARKS/REC DEPARTMENT (OLDER ADULTS, YOUTH, 3/17/15) - STARVISTA (CHILDREN & YOUTH, 4/9/2015) - SYNERGY HOMECARE (OLDER ADULTS, 3/11/15) 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 BENEFITS 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 CHILDREN'S HOSPITAL AT STANFORD'S ("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, O'CONNOR HOSPITAL, SAINT LOUISE REGIONAL HOSPITAL, SAN MATEO MEDICAL CENTER, SETON MEDICAL CENTER, SEQUOIA HOSPITAL, AND STANFORD HEALTH CARE. LPCH'S 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) IN ADDITION TO THESE 3 MAIN HEALTH INITIATIVES, LPCH HAS PRIORITIZED ADDRESSING MATERNAL HEALTH ISSUES DUE TO THE DISPARITIES AMONGST COMMUNITY MEMBERS THAT EXIST. 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 LPCH'S IMPLEMENTATION STRATEGY: BIRTH OUTCOMES: AS A FREESTANDING CHILDREN'S HOSPITAL OFFERING MATERNITY SERVICES, 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 LPCH'S 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. LPCH PLANS ON FUNDING PROGRAMS THAT SPECIFICALLY ADDRESS THESE DISPARITIES IN SUBSEQUENT TAX YEARS. AS MENTIONED PREVIOUSLY, LPCH DOES FUND PROGRAMS THAT SEEK TO ADDRESS THE DISPARITIES AROUND MATERNAL HEALTH AND BIRTH OUTCOMES. 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 LPCH'S 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 HTTP://WWW.STANFORDCHILDRENS.ORG/EN/PATIENT-FAMILY- RESOURCES/FINANCIAL-ASSISTANCE-ENGLISH?. IT IS ALSO AVAILABLE ON THE STATEMENTS SENT TO PATIENTS.
PART V, SECTION B, LINE 20A	LPCH DID NOT CONDUCT ANY OF THE ACTIONS LISTED IN LINE 19 OR ANY SIMILAR ACTIONS DURING FY 2018.
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) 2019

Page 9

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) 2019

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
PART I, LINE 7, COLUMN (F)	THE AMOUNT OF BAD DEBT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN LINE 7, COLUMN F WAS $4,698,074. PART I, LINE 7 SOME OF THE AMOUNTS IN LINE 7 WERE CALCULATED BASED ON A COST ACCOUNTING SYSTEM. THESE ITEMS INCLUDE CHARITY CARE AT COST, UNREIMBURSED MEDICAID COST, AND UNREIMBURSED COSTS RELATED TO OTHER MEANS-TESTED GOVERNMENT PROGRAMS. THE COST ACCOUNTING SYSTEM ADDRESSES ALL PATIENT SEGMENTS, BUT EXCLUDES RESEARCH AND SOME GRANT RELATED COSTS. OTHER BENEFIT COSTS ARE DIRECT, SEPARATELY IDENTIFIABLE COSTS INCURRED BY THE ORGANIZATION. PART II COMMUNITY BUILDING ACTIVITIES LPCH INVESTS IN VARIOUS COMMUNITY BUILDING ACTIVITIES IN ORDER TO IMPROVE THE COMMUNITY'S HEALTH THROUGH A FOCUS ON THE ROOT CAUSES OF HEALTH PROBLEMS, SUCH AS POVERTY, ENVIRONMENTAL ISSUES, ETC. LPCH'S COMMUNITY BUILDING ACTIVITIES INCLUDE: SUPPORT FOR COMMUNITY-BASED NON-PROFITS WORKING TO ADDRESS THE ROOT CAUSES OF HEALTH ISSUES FOR CHILDREN AND EXPECTANT MOTHERS, SUPPORT FOR COMMUNITY EMERGENCY MANAGEMENT, ADVOCACY FOR CHILDREN'S HEALTH ISSUES, AND SUPPORT FOR ORGANIZATIONS WORKING ON ECONOMIC DEVELOPMENT IN THE COMMUNITY.
PART III, LINE 2	THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNT REPORTED ON LINE 2 IS BASED ON A COST ACCOUNTING SYSTEM. THE HOSPITAL APPLIED THE SAME SYSTEM-WIDE COST TO CHARGE RATIO FROM THE COST ACCOUNTING SYSTEM TO ITS 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	THE MEDICARE SHORTFALL OF ($9,024,053) 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 LPCH'S 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 PATIENT'S 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 CHILDREN'S 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. 7) LPCH WORKS CLOSELY WITH OUR COMMUNITY BENEFIT GRANT PARTNERS TO UNDERSTAND THE NEEDS OF OUR COMMUNITY. BEGINNING IN FY2016, LPCH WAS DETERMINED TO DEEPEN THE CONNECTION BETWEEN INDIVIDUAL COMMUNITY BENEFIT GRANT PARTNERS IN ORDER TO BETTER UNDERSTAND THEIR WORK WITH UNDERSERVED POPULATIONS. IN ORDER TO DO THIS, WE CREATED A FULL DAY MINI-CONFERENCE WHERE GRANTEES COULD FOCUS ON BUILDING CONNECTIONS AMONG THEMSELVES AND LEARN FROM COMMUNITY HEALTH EXPERTS IN ORDER TO FOSTER DEEPER COMMUNITY COLLABORATION. THE GRANTEE COLLABORATIVE IS NOW AN ANNUAL EVENT AND AN INTEGRAL COMPONENT OF OUR OVERALL COMMUNITY HEALTH IMPROVEMENT EFFORTS. THE CONTENT OF THE DAY CHANGES ANNUALLY BUT THE FOCUS REMAINS ON BUILDING ORGANIZATIONAL SUSTAINABILITY THROUGH SHARING OF BEST PRACTICES, EXPERT-LED PRESENTATIONS AND SMALL GROUP WORKSHOPS. 8) BEGINNING IN FY2017 LPCH INVESTED HEAVILY IN A PROCESS THAT WOULD HELP US BETTER UNDERSTAND THE IMPACT OF OUR COMMUNITY HEALTH IMPROVEMENT EFFORTS ON THE UNDERSERVED MEMBERS OF OUR COMMUNITY. WE PARTNERED WITH PUBLIC HEALTH EXPERTS TO EVALUATE OUR CURRENT EFFORTS AND TO IMPROVE OUR DATA COLLECTION PROCESSES AND REPORTING.
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 CHILDREN'S 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 LPCH'S INPATIENT PEDIATRIC CASES (EXCLUDING NORMAL NEWBORNS) AND 85 PERCENT OF OBSTETRICS CASES COME FROM SCC AND 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. SMC'S 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 RACE AND 5 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 FAMILY'S 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 CALIFORNIA'S 58 COUNTIES, AND THE MOST POPULATED COUNTY IN THE BAY AREA. MORE THAN HALF OF THE RESIDENTS LIVE IN SAN JOSE. SCC'S 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 COUNTY'S 15 CITIES AND MORE THAN 88 PERCENT OF THE COUNTY'S RESIDENTS LIVE IN THE NORTH COUNTY. GILROY AND MORGAN HILL, WITH APPROXIMATELY 5 PERCENT OF THE COUNTY'S 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 U.S. 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 FAMILY'S BASIC NEEDS, THE EQUIVALENT OF FOUR FULL-TIME SCC MINIMUM WAGE JOBS.
PART VI, LINE 5	LUCILE SALTER PACKARD CHILDREN'S 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 FY2017 AND FY2018 COMMUNITY BENEFIT REPORT AND IMPLEMENTATION PLANS FILED FEBRUARY 2017 AND FEBRUARY 2018 WITH THE STATE OF CALIFORNIA OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT. A THOROUGH ACCOUNTING OF THE HOSPITAL'S EFFORTS TO PROMOTE COMMUNITY HEALTH CAN BE READ IN THE REPORT, WHICH IS AVAILABLE AT COMMUNITYBENEFIT.STANFORDCHILDRENS.ORG BELOW IS A LISTING OF LPCH'S SERVICES AND ACTIVITIES THAT PROMOTE THE HEALTH OF THE COMMUNITY WE SERVE: HEALTH PROFESSIONS EDUCATION THE HOSPITAL IS A MAJOR EMPLOYER IN THE COMMUNITY IT SERVES AND, AS AN ACADEMIC MEDICAL CENTER, INVESTS SIGNIFICANTLY IN TRAINING THE HEALTH-CARE PROFESSIONALS OF THE FUTURE. THE HOSPITAL IS A MAJOR PROVIDER OF TRAINING FOR RESIDENT PHYSICIANS, FELLOWS AND MEDICAL STUDENTS, NURSES, AND ALLIED HEALTH PROFESSIONS FROM AROUND THE REGION FROM VARIOUS ORGANIZATIONS. THE HOSPITAL PROVIDES ANNUAL FUNDING FOR PEDIATRIC RESIDENTS ADVOCACY AND COMMUNITY HEALTH TRAINING AND PARTICIPATES IN STATE AND NATIONAL 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 HEALTH IMPROVEMENT GRANTS AT LPCH WE BELIEVE THAT WE CAN IMPACT THE HEALTH OF OUR COMMUNITY ON AN EVEN DEEPER LEVEL WHEN WE PARTNER WITH EXISTING COMMUNITY-BASED ORGANIZATIONS THAT ARE WORKING ON SHARED HEALTH INITIATIVES. WE ARE DEDICATED TO INVESTING IN LOCAL NONPROFITS THROUGH OUR COMMUNITY HEALTH IMPROVEMENT GRANTS PROGRAM. ANNUALLY, WE FUND A WIDE ARRAY OF PROGRAMS AND PROJECTS SEEKING TO IMPROVE THE HEALTH OF OUR COMMUNITY. COMMUNITY BUILDING ACTIVITIES THE HOSPITAL PARTICIPATES IN A MYRIAD OF COMMUNITY BUILDING ACTIVITIES THAT SEEK TO IMPROVE THE COMMUNITY'S 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 CHILDREN'S HEALTH ISSUES. ACADEMIC MEDICAL CENTER - RESEARCH LPCH IS PART OF STANFORD UNIVERSITY SCHOOL OF MEDICINE, THE WEST COAST'S 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 CHILDREN'S 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 CHILDREN'S 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) 2019

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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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

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	(h) Purpose of grant or assistance
(1) CHALLENGE SUCCESS PO BOX 20053 STANFORD,CA94309	45-3767621	501 (C) (3)	37,500	SUPPORT THE SOCIAL AND EMOTIONAL HEALTH OF YOUTH AND ADOLESCENTS
(2) SAN MATEO MEDICAL CENTER 222 W 39TH AVE SAN MATEO,CA94403	94-6000532	GOVERNMENT	300,000	SUPPORT THE SAN MATEO COUNTY CHILDREN'S HEALTH INITIATIVE COMMUNITY OUTREACH GRANT AND THE LABOR, DELIVERY AND PRENATAL SERVICES PROJECT
(3) LEGAL AID SOCIETY OF SAN MATEO COUNTY 330 TWIN DOLPHIN DR STE 123 REDWOOD CITY,CA94065	94-1451894	501 (C) (3)	50,000	SUPPORT TO IMPROVE ACCESS TO PRIMARY HEALTHCARE SERVICES
(4) MARCH OF DIMES 1101 S WINCHESTER BLVD STE E155 SAN JOSE,CA95128	13-1846366	501 (C) (3)	9,000	SUPPORT MARCH OF DIMES EVENTS
(5) MAYVIEW COMMUNITY HEALTH CENTER 270 GRANT AVENUE PALO ALTO,CA94306	94-2239648	501 (C) (3)	50,000	SUPPORT THE PRIMARY HEALTH CARE SERVICES
(6) PEER HEALTH EXCHANGE INC 70 GOLD STREET SAN FRANCISCO,CA94133	56-2374305	501 (C) (3)	50,000	SUPPORT IMPROVEMENTS OF SOCIAL AND EMOTIONAL HEALTH OF YOUTH AND ADOLESCENTS
(7) PUENTE DE LA COSTA SUR 620 NORTH STREET PESCADERO,CA94060	37-1484262	501 (C) (3)	70,000	SUPPORT TO IMPROVE ACCESS TO PRIMARY HEALTHCARE SERVICES
(8) SANTA CRUZ COMMUNITY HEALTH CENTERS 125 WATER STREET SUITE A-2 SANTA CRUZ,CA95060	23-7428303	501 (C) (3)	65,000	SUPPORT TO IMPROVE ACCESS TO PRIMARY HEALTHCARE SERVICES
(9) UNITED WAY OF SANTA CRUZ COUNTY 4450 CAPITOLA RD 106 CAPITOLA,CA95010	94-1422471	501 (C) (3)	65,000	SUPPORT THE HEALTH PROGRAM EDUCATION TO REDUCE PEDIATRIC OBESITY
(10) YMCA OF SILICON VALLEY 80 SARATOGA AVENUE SANTA CLARA,CA95051	94-1156318	501 (C) (3)	85,000	SUPPORT IMPROVEMENTS OF SOCIAL AND EMOTIONAL HEALTH OF YOUTH AND ADOLESCENTS
(11) ABILITIES UNITED 525 E CHARLESTON ROAD PALO ALTO,CA94306	94-1546643	501 (c)(3)	10,000	ADVANCES ADVOCACY, INCLUSION, AND INDEPENDENCE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES.
(12) GEORGE MARK CHILDREN'S FUND 212 GEORGE MARK LANE SAN LEANDRO,CA94578	94-3255845	501 (c) (3)	10,000	SUPPORT FOR HEALTH CARE SUPPORT SERVICES FOR THE BROADER UNDERSERVED COMMUNITY.
(13) JOHN MUIR HEALTH FOUNDATION 140 TREAT BOULEVARD WALNUT CREEK,CA94597	94-2650855	501 (c) (3)	10,000	SUPPORT FOR PRIMARY HEALTH CARE SERVICE FOR THE BROADER COMMUNITY.
(14) REDWOOD CITY CHAMBER OF COMMERCE 1450 VETERANS BOULEVARD SUITE 125 REDWOOD CITY,CA94063	94-0377914	501 (c) (3)	8,720	SUPPORT FOR ADVOCACY FOR SOCIAL DETERMINANTS OF HEALTH IN BROADER COMMUNITY.
(15) TEEN SUCCESS INC 508 VALLEY WAY MILPITAS,CA95035	47-0702884	501 (c) (3)	30,000	EMPOWERS YOUNG MOTHERS TO GRADUATE HIGH SCHOOL AND BREAK OUT OF THE CYCLE OF POVERTY FOR THEMSELVES AND THEIR CHILDREN.
(16) TALK READ SING FIRST 5 CALIFORNIA SAN MATEO COUNT 1700 SOUTH EL CAMINO REAL SUITE 40 SAN MATEO,CA94402	77-0548254	GOVERNMENT	70,000	COMMUNITY HEALTH EDUCATION GRANT FOR EARLY CHILDHOOD LITERACY.
(17) SOUTH COUNTY COMMUNITY HEALTH CENTER 1885 BAY ROAD EAST PALO ALTO,CA94303	94-3372130	501(C)(3)	369,000	SUPPORT RAVENSWOOD HEALTH 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) 2019

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 noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash 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 ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE UNITED STATES. IN ADDITION TO ALL OTHER RELEVANT COMMUNITY BENEFIT SERVICES AND ACTIVITIES, LPCH ACTIVELY FUNDS GRANTS TO LOCAL COMMUNITY BASED ORGANIZATIONS WORKING TO IMPROVE THE HEALTH STATUS OF THE COMMUNITY. THE MAJORITY OF GRANTS ARE MADE TO ORGANIZATIONS WORKING TO IMPROVE HEALTH NEEDS IDENTIFIED THROUGH THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT AND PRIORITIZED BY THE HOSPITAL. ADDITIONAL GRANTS ARE, AT TIMES, MADE TO ORGANIZATIONS WORKING TO ADDRESS HEALTH NEEDS THAT HAVE BEEN IDENTIFIED BY OTHER RESEARCH OR DATA. RATHER THAN CONDUCTING A REQUEST FOR PROPOSAL GRANT PROCESS, LPCH IDENTIFIES AND SOLICITS COMMUNITY ORGANIZATIONS TO APPLY FOR GRANTS, PARTICIPATE IN A GRANT SELECTION PROCESS, AND THEN BE "AWARDED" A GRANT THROUGH AN INTERNAL PROCESS. THIS INTERNAL PROCESS IS GUIDED BY BOTH HOSPITAL LEADERSHIP AND A COMMUNITY ADVISORY BOARD. WHEN SELECTING WHICH ORGANIZATIONS TO GRANT FUNDS 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, IDENTIFIES EXISTING PROJECTS THAT POSE AN OPPORTUNITY FOR PARTNERSHIP AND HAVE THE POTENTIAL TO POSITIVELY IMPACT COMMUNITY HEALTH AND THEN INVITES THE COMMUNITY BASED ORGANIZATION TO APPLY FOR A COMMUNITY HEALTH IMPROVEMENT GRANT, AND IF APPROVED, 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 HOSPITAL'S PRIMARY OR SECONDARY SERVICE AREA THAT SHARES THE HOSPITAL'S COMMUNITY BENEFIT MISSION OF IMPROVING THE HEALTH STATUS OF LOCAL CHILDREN, ADOLESCENTS OR PREGNANT WOMEN WITH A FOCUS ON SERVING THE COMMUNITY'S MOST VULNERABLE. IN COLLABORATION WITH THE GRANTEE ORGANIZATION'S LEADERSHIP, GRANT GOALS AND METRICS ARE DETERMINED ANNUALLY PRIOR TO FUNDING BEING AWARDED. A PROGRESS REPORT IS REQUIRED AT SIX MONTHS AND ACCOMPANIED BY A MID-YEAR PROGRESS CONFERENCE CALL, 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. WE ALSO INVEST HEAVILY IN COMMUNITY BENEFIT STRATEGIC PLANNING SERVICES LED BY PUBLIC HEALTH EXPERTS WITH YEARS OF EXPERIENCE IN COMMUNITY HEALTH IMPROVEMENT. LPCH'S GRANT MAKING DECISIONS RECEIVE OVERSIGHT FROM BOTH THE COMMUNITY BENEFIT ADVISORY COUNCIL, COMPRISED OF COMMUNITY LEADERS AND EXPERTS, AS WELL AS THE LPCH BOARD OF DIRECTORS. BOTH THE COMMUNITY BENEFIT ADVISORY COUNCIL AND THE LPCH BOARD OF DIRECTORS MEET QUARTERLY THROUGHOUT THE YEAR TO REVIEW COMMUNITY BENEFIT ACTIVITIES AND SPENDING. LPCH HAS DEDICATED COMMUNITY BENEFIT STAFF WHO, UNDER THE DIRECTION OF THE CHIEF GOVERNMENT AND COMMUNITY RELATIONS OFFICER, CONDUCTS 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 HOSPITAL'S ONE-TIME GRANT AWARDS ARE: KIDS IN COMMON'S CHILDREN'S AGENDA 2017 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 $30,000 RANGE TO SPONSOR BOTH EDUCATIONAL AND FUNDRAISING EVENTS FOR ORGANIZATIONS SUCH AS THE MARCH OF DIMES, RONALD MCDONALD HOUSE, JUVENILE DIABETES RESEARCH FOUNDATION, FEDERALLY QUALIFIED HEALTH CENTERS, ETC.

Schedule I (Form 990) 2019

Additional Data

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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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

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 on 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 on 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 nonfixed
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) 2019

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 DAWES PRESIDENT/CEO (UNTIL 3/2018)	(i) (ii)	979,769 ------------- 0	151,000 ------------- 0	2,576,566 ------------- 0	1,242,300 ------------- 0	42,057 ------------- 0	4,991,692 ------------- 0	1,800,000 ------------- 0
2DENNIS P LUND MD DIRECTOR/CMO	(i) (ii)	0 ------------- 389,149	0 ------------- 485,163	0 ------------- 29,696	0 ------------- 16,902	0 ------------- 37,742	0 ------------- 958,652	0 ------------- 0
3DAVID ALEXANDER MD DIRECTOR (Until 3/2018)	(i) (ii)	0 ------------- 549,168	0 ------------- 158,750	0 ------------- 218,382	0 ------------- 26,500	------------- 40,486	0 ------------- 993,286	0 ------------- 93,243
4DAVID ENTWISTLE DIRECTOR	(i) (ii)	0 ------------- 1,605,703	0 ------------- 768,009	0 ------------- 49,532	0 ------------- 305,599	0 ------------- 51,964	0 ------------- 2,780,807	0 ------------- 0
5JAMES DUNN DIRECTOR	(i) (ii)	0 ------------- 600,643	0 ------------- 446,099	0 ------------- 49,479	0 ------------- 2,100	0 ------------- 46,368	0 ------------- 1,144,689	0 ------------- 0
6MARY LEONARD MD DIRECTOR	(i) (ii)	0 ------------- 433,701	0 ------------- 320,292	0 ------------- 600	0 ------------- 18,900	0 ------------- 2,643	0 ------------- 776,136	0 ------------- 0
7RANDY LIVINGSTON DIRECTOR (AS OF 10/17)	(i) (ii)	0 ------------- 687,644	0 ------------- 0	0 ------------- 200	0 ------------- 249,222	0 ------------- 31,993	0 ------------- 969,059	0 ------------- 0
8LLOYD B MINOR MD DIRECTOR	(i) (ii)	0 ------------- 1,467,861	0 ------------- 250,000	0 ------------- 1,925,159	0 ------------- 124,300	0 ------------- 39,518	0 ------------- 3,806,838	0 ------------- 1,306,452
9BRIAN PERRONNE DIRECTOR (AS OF 3/2018)	(i) (ii)	0 ------------- 396,137	0 ------------- 93,956	0 ------------- 23,599	0 ------------- 79,971	0 ------------- 26,605	0 ------------- 620,268	0 ------------- 14,269
10CHRISTY SANDBORG MD DIRECTOR	(i) (ii)	0 ------------- 277,529	0 ------------- 200,537	0 ------------- 0	0 ------------- 25,897	0 ------------- 20,857	0 ------------- 524,820	0 ------------- 0
11ANNE MCCUNE CHIEF OPERATING OFFICER	(i) (ii)	132,161 ------------- 0	0 ------------- 0	564,014 ------------- 0	21,560 ------------- 0	11,480 ------------- 0	729,215 ------------- 0	0 ------------- 0
12DANA HAERING VP & CFO	(i) (ii)	483,334 ------------- 0	30,000 ------------- 0	108,681 ------------- 0	90,310 ------------- 0	13,756 ------------- 0	726,081 ------------- 0	50,671 ------------- 0
13CAMERON D'ALPE CAO PHYSICIAN PRAC & CEO PCHA	(i) (ii)	334,448 ------------- 0	30,000 ------------- 0	40,826 ------------- 0	69,948 ------------- 0	17,999 ------------- 0	493,221 ------------- 0	23,737 ------------- 0
14KELLY JOHNSON VP PATIENT CARE SERVICES & CNO	(i) (ii)	413,636 ------------- 0	30,000 ------------- 0	194,191 ------------- 0	97,479 ------------- 0	28,345 ------------- 0	763,651 ------------- 0	0 ------------- 0
15EDWARD KOPETSKY VP & CIO	(i) (ii)	492,192 ------------- 0	30,000 ------------- 0	76,548 ------------- 0	47,068 ------------- 0	33,728 ------------- 0	679,536 ------------- 0	0 ------------- 0
16MICHAEL LANE VP LPCH CONSTRUCTION	(i) (ii)	470,401 ------------- 0	30,000 ------------- 0	57,310 ------------- 0	92,670 ------------- 0	28,427 ------------- 0	678,808 ------------- 0	46,654 ------------- 0
17KRISTIN PETERSEN VP PROCED & DIAGNOSTIC SERVICE	(i) (ii)	388,610 ------------- 0	30,000 ------------- 0	1,163 ------------- 0	68,402 ------------- 0	51,757 ------------- 0	539,932 ------------- 0	0 ------------- 0
18KIM ROBERTS CHIEF STRATEGY OFFICER	(i) (ii)	530,438 ------------- 0	30,000 ------------- 0	194,303 ------------- 0	53,980 ------------- 0	13,945 ------------- 0	822,666 ------------- 0	52,813 ------------- 0
19HELEN WILMOT SHC ADMIN - COO	(i) (ii)	0 ------------- 379,869	0 ------------- 66,051	0 ------------- 244	0 ------------- 52,443	0 ------------- 0	0 ------------- 498,607	0 ------------- 0
20ROBERT POOLE PHARMACY	(i) (ii)	103,063 -------------	34,700 ------------- 0	363,561 ------------- 0	0 ------------- 0	0 ------------- 0	501,324 ------------- 0	0 ------------- 0
21GREGORY J SOUZA CHRO	(i) (ii)	356,116 ------------- 0	83,333 ------------- 0	65,146 ------------- 0	56,650 ------------- 0	3,637 ------------- 0	564,882 ------------- 0	0 ------------- 0
22ROSALINDA LUNA CLINICAL NURSE IV	(i) (ii)	462,875 ------------- 0	1,500 ------------- 0	0 ------------- 0	52,840 ------------- 0	10,952 ------------- 0	528,167 ------------- 0	0 ------------- 0
23MARK TORTORICH VP DESG,PLAN,CONST(UNTIL 2/17)	(i) (ii)	0 ------------- 41,399	0 ------------- 0	0 ------------- 428,915	0 ------------- 15,067	0 ------------- 2,881	0 ------------- 488,262	0 ------------- 0
24LISA GRISIM VP & ASSOCIATE CIO	(i) (ii)	397,861 ------------- 0	30,000 ------------- 0	7,655 ------------- 0	76,096 ------------- 0	28,750 ------------- 0	540,362 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2019

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 TWO OFFICERS AND TWO KEY EMPLOYEES RECEIVED HOUSING AS A TAXABLE BENEFIT AND THE AMOUNT HAS BEEN INCLUDED IN SCHEDULE J, PART II, COLUMN B(III).
SCHEDULE J, PART I, LINE 4A	ROBERT POOLE RECEIVED SEVERANCE IN CY2017 OF $318,546. ANNE MCCUNE RECEIVED A SEVERANCE PAYMENT ON 3/31/17 IN THE AMOUNT OF $433,433, AND A SECOND PAYMENT ON 5/9/18. THE MARCH 2017 PAYMENT IS DISCLOSED ON SCHEDULE J, PART II, COLUMN B(III). MARK TORTORICH RECEIVED SEVERANCE IN CY2017 OF $342,077. SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN SCHEDULE J, PART I, LINE 4B LPCH, LPFCH, 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; (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 2017: DAVID ALEXANDER 191,444 CAMERON D' ALPE 24,018 CHRISTOPHER DAWES 170,729 LISA GRISIM 3,841 DANA HAERING 52,045 KELLY JOHNSON 5,654 EDWARD KOPETSKY 61,175 MICHAEL LANE 47,736 BRIAN PERRONNE 14,269 KIM ROBERTS 162,565 GREGORY J. SOUZA 43,450 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 HAD TWO NONQUALIFIED DEFERRED COMPENSATION ARRANGEMENTS. UNDER THE FIRST ARRANGEMENT, MR. DAWES RECEIVED CREDITS TO HIS ACCOUNT THROUGH 2016 PROVIDED HE REMAINED EMPLOYED IN HIS CURRENT POSITION. THIS BALANCE OF $2,375,967 WAS PAID IN MARCH OF 2017. UNDER THE SECOND ARRANGEMENT, MR. DAWES RECEIVED AN ADDITIONAL CREDIT TO HIS ACCOUNT WITH PAYMENT CONTINGENT ON CONTINUED SERVICE THRORUGH APRIL 1, 2018. LLOYD B. MINOR AND RANDY LIVINGSTON PARTICIPATE IN A DEFERRED COMPENSATION PLAN AT STANFORD UNIVERSITY, A RELATED ORGANIZATION. ANNUALLY, AMOUNTS ARE CREDITED TO THE PLAN BASED ON PERFORMANCE AND CERTAIN OTHER FACTORS. THESE AMOUNTS APPEAR IN SCHEDULE J, PART II, COLUMN (C). PLAN BALANCES ARE SUBJECT TO FORFEITURE AND/OR PAYMENT ONLY IF CERTAIN CONDITIONS ARE MET.
SCHEDULE J, PART I, LINE 7	CERTAIN OFFICERS AND OTHERS AS LISTED 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) 2019

Additional Data

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Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

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 Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

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 FINANCE AUTHORITY	52-1643828	13033LWR4	03-21-2012	270,684,581	SEE PART VI		X		X		X
B	CALIFORNIA HEALTH FACILITIES FINANCE AUTHORITY	52-1643828	13033L3G0	05-08-2014	208,381,669	FINANCE HEALTH FACILITIES		X		X		X
C	CALIFORNIA HEALTH FACILITIES FINANCE AUTHORITY	52-1643828	13032UDC9	03-31-2016	206,377,852	SEE PART VI		X		X		X
D	CALIFORNIA HEALTH FACILITIES FINANCE AUTHORITY	52-1643828	13032UPX0	08-17-2017	229,068,542	FINANCE HEALTH FACILITIES		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	0		0		0		0
2 Amount of bonds legally defeased ..............	0		0		0		0
3 Total proceeds of issue ..................	270,684,581		208,381,669		206,377,852		229,068,542
4 Gross proceeds in reserve funds .............	0		0		0		0
5 Capitalized interest from proceeds .............	0		0		0		0
6 Proceeds in refunding escrows ...............	0		0		0		0
7 Issuance costs from proceeds ...............	2,687,575		1,996,822		2,018,933		2,182,977
8 Credit enhancement from proceeds .............	0		0		0		0
9 Working capital expenditures from proceeds .............	0		0		0		0
10 Capital expenditures from proceeds .............	210,636,980		206,870,271		113,527,667		227,083,531
11 Other spent proceeds .............	58,857,496		0		91,100,236		0
12 Other unspent proceeds .............	0		0		0		0
13 Year of substantial completion .............	2018		2018
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2018, a current refunding issue)? ........
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2018, an advance refunding issue)? ........
16 Has the final allocation of proceeds been made? ..........	X		X		X			X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

Part Ⅲ

Private Business Use

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

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

Cat. No. 50193E

Schedule K (Form 990) 2019

Page 2

Part Ⅲ

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %		0 %		0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........
6 Total of lines 4 and 5 .............
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............		X		X		X		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

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

Schedule K (Form 990) 2019

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........	0		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		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

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

Return Reference

Explanation

SCHEDULE K, 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 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 ADVANCE SCHEDULE K, PART IV, LINE 2C, COLUMN A (2012 BONDS) AN ARBITRAGE REBATE ANALYSIS WAS PERFORMED FOR 2012 SERIES A AND B BONDS ON MARCH 22, 2018. NO PAYMENT WAS DUE TO THE IRS FOR THESE BONDS IN FY2018. SCHEDULE K, PART IV, LINE 2C, COLUMN C (2016 BONDS) AN ARBITRAGE REBATE ANALYSIS WAS PERFORMED FOR 2016 SERIES A AND B BONDS ON APRIL 13, 2018. NO PAYMENT WAS DUE TO THE IRS FOR THESE BONDS IN FY2018.

Schedule K (Form 990) 2019

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

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 section 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 the 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) 2019

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) CAROLINE HOEVELER	EMPLOYEE IS A FAMILY MEMBER OF A BOARD MEMBER.	84,936	EMPLOYEE COMPENSATION		No
(2) ELIZABETH DAWES	EMPLOYEE IS A FAMILY MEMBER OF AN OFFICER.	106,841	EMPLOYEE COMPENSATION		No
(3) ANGELA KOPETSKY	EMPLOYEE IS A FAMILY MEMBER OF A KEY EMPLOYEE.	239,540	EMPLOYEE COMPENSATION		No

Part V

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

Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

LUCILE SALTER PACKARD CHILDREN'S
HOSPITAL AT STANFORD

Employer identification number

77-0003859

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .	X	27	3,431,008	FMV
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( )
26 Other ( )
27 Other ( )
28 Other ( )

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which isn't required to be used for exempt purposes for the entire holding period? ...................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

If "Yes," describe in Part II.

If the organization didn't report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

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

Cat. No. 51227J

Schedule M (Form 990) (2019)

Page 2

Part IISupplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Return Reference	Explanation

Schedule M (Form 990) (2019)

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

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 JOHNSON CENTER EXPENSE $393,598,000 GRANTS $0 REVENUE $386,233,000 THE JOHNSON CENTER FOR PREGNANCY AND NEWBORN SERVICES 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 CHILDREN'S HOSPITAL AT STANFORD TO DELIVER THEIR PATIENTS. THE JOHNSON CENTER'S SERVICES INCLUDE PRENATAL DIAGNOSIS, GENETIC COUNSELING, HIGH RESOLUTION FETAL ULTRASOUND SERVICES, HIGH RISK PRENATAL CARE, DELIVERY, LACTATION AND PARENTING SUPPORT AND NEWBORN INTENSIVE CARE. IN ADDITION, THE BEHAVIORAL-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, MODESTO, 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. IN FISCAL YEAR 2018, THERE WERE 4,880 OBSTETRIC DISCHARGES FROM THE JOHNSON CENTER, AND 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, 13% PERCENT OF PATIENTS CAME FROM THE SURROUNDING BAY AREA COUNTIES, AND 1% FROM THE REMAINING CALIFORNIA COUNTIES AND OUT OF STATE. NEONATOLOGY SERVED A TOTAL OF 1,303 INPATIENTS IN FISCAL YEAR 2018 WITH AN AVERAGE LENGTH OF STAY OF 12.7 DAYS. OF THESE INPATIENTS, 67% WERE FROM THE PRIMARY SERVICE AREA, 26% FROM THE SURROUNDING BAY AREA COUNTIES, AND 7% FROM OUTSIDE THE BAY AREA. FORM 990, PART III, LINE 4B PROGRAM SERVICE DESCRIPTION MOORE CHILDREN'S HEART CENTER EXPENSE $304,289,000 GRANTS $0 REVENUE $357,266,000 THE MOORE CHILDREN'S HEART CENTER'S VISION IS TO BRING TOGETHER PROFESSIONAL AND FACILITY RESOURCES UNDER ONE CENTER OF EXCELLENCE THAT SERVES BOTH OUR LOCAL PATIENTS AND THE GREATER COMMUNITY. WITH A MULTIDISCIPLINARY TEAM SPECIALLY TRAINED TO DIAGNOSE AND TREAT INFANTS, CHILDREN, AND YOUNG ADULTS WITH CONGENITAL AND ACQUIRED HEART DISEASES, THE HEART CENTER CARES FOR CHILDREN REQUIRING SPECIALIZED CARDIOTHORACIC SERVICES ON A NATIONAL AND INTERNATIONAL BASIS, DRAWING PATIENTS FROM ALL OVER CALIFORNIA, AT LEAST 36 DIFFERENT STATES, AND SEVERAL FOREIGN 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 2018, OUR VENTRICULAR ASSIST DEVICE PROGRAM CONTINUED TO GROW TO CARE FOR THE SICKEST OF CHILDREN WITH ADVANCED HEART FAILURE, AND WE IMPLANTED 15 ASSIST DEVICES IN A SINGLE FISCAL YEAR. 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 1029 IN FISCAL YEAR 2018. OF THESE, THERE WERE 25 HEART TRANSPLANTS. THE PROGRAM HAD A CASE MIX INDEX OF 4.9 REFLECTING THE HIGHLY COMPLEX POPULATION THAT WE SERVE. 22% OF PATIENTS CAME FROM OUR PRIMARY SERVICE AREA OF SAN MATEO AND SANTA CLARA COUNTIES, 31% CAME FROM SURROUNDING BAY AREA COUNTIES, 29% CAME FROM OTHER AREAS WITHIN CALIFORNIA, AND 18% FROM OTHER STATES IN FISCAL YEAR 2018.
FORM 990, PART III, LINE 4C	PROGRAM SERVICE DESCRIPTION BASS CANCER CENTER EXPENSE $177,385,000 GRANTS $0 REVENUE $169,269,000 THE BASS CENTER FOR CHILDHOOD CANCER AND BLOOD DISEASES 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 9-BED DAY HOSPITAL, INFUSION ROOM, LAB AND CLINIC. THE CANCER CENTER IS STAFFED BY INDIVIDUALS TRAINED IN THE SPECIALIZED NEEDS OF PEDIATRIC CANCER PATIENTS AND INCLUDES APPROPRIATE ISOLATION ROOMS. IN NOVEMBER 2019, THE BASS CANCER CENTER WILL MOVE TO ITS NEW STATE-OF THE ART 49 BED INPATIENT UNIT LOCATED ON THE 5TH FLOOR OF THE NEW HOSPITAL EXPANSION. THE PROGRAM DIAGNOSES AND TREATS APPROXIMATELY 280 NEW CANCER PATIENTS PER YEAR AND PERFORMED 41 STEM CELL TRANSPLANTS IN FISCAL YEAR 2018. 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 CENTER'S 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 2018 TOTALED 1,024 WITH AN AVERAGE LENGTH OF STAY OF 9.9 DAYS. THE CANCER CENTER IS A STRONG REGIONAL PROGRAM WITH 45% OF PATIENTS COMING FROM THE PRIMARY SERVICE AREA OF SAN MATEO AND SANTA CLARA COUNTIES, 41% FROM THE SURROUNDING BAY AREA COUNTIES, 12% FROM OTHER CALIFORNIA COUNTIES AND 2% FROM OUTSIDE THE STATE OF CALIFORNIA. FORM 990, PART III, LINE 4D PROGRAM SERVICE DESCRIPTION OTHER PROGRAMS EXPENSE $ 516,130,982 GRANTS $1,304,220 REVENUE $591,582,306 IN ADDITION TO THE THREE CENTERS DESCRIBED ABOVE, LPCH PROVIDES CLINICAL SERVICES THROUGH THREE ADDITIONAL CENTERS OF EXCELLENCE: -BRAIN AND BEHAVIOR CENTER 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 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 HOSPITAL'S CENTER FOR BRAIN TUMORS IS ONE OF THE LEADING PROGRAMS IN THE COUNTRY. THE EATING DISORDER PROGRAM LINKS AN INPATIENT PROGRAM WITH AN EVIDENCE-BASED OUTPATIENT PROGRAM THAT COORDINATES MEDICAL AND PSYCHIATRIC TREATMENT. IN ALL OF THE BRAIN AND BEHAVIOR CENTER'S PROGRAMS, PSYCHIATRISTS, PSYCHOLOGISTS, NEUROSURGEONS, AND NEUROLOGISTS WORK CLOSELY WITH BASIC RESEARCHERS TO DISCOVER THE INNER WORKINGS OF THE BRAIN AND HOW IT IMPACTS BEHAVIOR SO THAT CHILDREN COPING WITH COMPLEX CONDITIONS MAY LEAD MORE FULL AND PRODUCTIVE LIVES. -PULMONARY MEDICINE AND CYSTIC FIBROSIS CENTER THIS CENTER INTEGRATES AN INTERDISCIPLINARY TEAM OF CLINICIANS AND RESEARCHERS FROM PACKARD CHILDREN'S 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 PULMONARY MEDICINE AND CYSTIC FIBROSIS 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 PULMONARY MEDICINE AND CYSTIC FIBROSIS 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. -TRANSPLANT CENTER THIS CENTER PERFORMS PEDIATRIC KIDNEY, LIVER AND INTESTINAL TRANSPLANTS AND SPECIALIZES IN DIALYSIS AND TRANSPLANTATION OF INFANTS, CHILDREN, AND HIGHLY COMPLEX CASES. THE TRANSPLANT PROGRAM RANKS AMONG THE TOP PROGRAMS IN THE NATION IN THE NUMBER OF PEDIATRIC KIDNEY AND LIVER TRANSPLANTS PERFORMED AND CONTINUES TO DELIVER OUTCOMES AMONG THE BEST IN THE COUNTRY. THE TRANSPLANT TEAM HAS PIONEERED NEW APPROACHES TO IMMUNOSUPPRESSION AND CONTINUES TO DEVELOP AND IMPLEMENT INNOVATIVE TREATMENT STRATEGIES TO REDUCE POST-TREATMENT COMPLICATIONS AND IMPROVE OUTCOMES. ADDITIONALLY, RESEARCH AND EDUCATION ARE PRIMARY COMPONENTS OF THE HOSPITAL'S MISSION AND INTEGRAL TO THE HOSPITAL'S CLINICAL OPERATIONS. THE HOSPITAL IS COMMITTED TO SUPPORTING AND FUNDING QUALITY GRADUATE MEDICAL EDUCATION PROGRAMS AND EXCELLENCE IN RESIDENCY TRAINING AND RESEARCH. LPCH CURRENTLY SPONSORS 35 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. LCPH PARTNERS WITH STANFORD SCHOOL OF MEDICINE TO CONDUCT RESEARCH IN ALL SIX CENTERS OF EXCELLENCE DESCRIBED ABOVE. LPCH 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 COMMUNITY'S 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 CHILDREN'S 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 CHILDREN'S HEALTH INSURANCE INITIATIVES - COMMUNITY BUILDING ACTIVITIES - ADVOCACY FOR CHILDREN'S 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 HOSPITAL'S PRIMARY SERVICE AREA, NEARLY ALL CHILDREN ARE ELIGIBLE FOR HEALTH INSURANCE COVERAGE THROUGH EITHER GOVERNMENT-SPONSORED OR LOCAL INITIATIVE INSURANCE PROGRAMS. HOWEVER, NEARLY ALL OF THESE PROGRAMS REIMBURSE THE HOSPITAL AT AMOUNTS FAR LESS THAN THE COST OF SERVICES PROVIDED. ADDITIONALLY, PATIENTS WHO MEET CERTAIN CRITERIA UNDER THE HOSPITAL'S CHARITY CARE POLICY RECEIVE SERVICES WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES.
EXECUTIVE COMMITTEE	FORM 990, PART VI, LINE 1A IF A MATTER NORMALLY REQUIRING ACTION BY THE BOARD OF DIRECTORS ARISES BETWEEN MEETINGS OF THE BOARD AND IS A MATTER 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 JEFF CHAMBERS, JAMES DUNN, DENNIS LUND, LLOYD MINOR, MARY LEONARD, RANDY LIVINGSTON, AND CHRISTY SANDBORG ARE EMPLOYEES OF STANFORD UNIVERSITY. LLOYD MINOR IS THE DEAN OF THE STANFORD SCHOOL OF MEDICINE. VAUGHN WILLIAMS IS A TRUSTEE OF STANFORD UNIVERSITY. DAVID ALEXANDER WAS THE CEO AND A DIRECTOR OF LUCILE PACKARD FOUNDATION FOR CHILDREN'S HEALTH (LPFCH). BRIAN PERRONNE IS THE INTERIM CEO AND A DIRECTOR OF LPFCH. CHRISTOPHER DAWES, ELAINE CHAMBERS, JEFF CHAMBERS, MARY LEONARD, DENNIS LUND, LLOYD MINOR, SUSAN ORR, AND MINDY ROGERS ARE DIRECTORS OF LPFCH. DAVID ENTWISTLE IS PRESIDENT AND CEO OF SHC. MARK TORTORICH AND HELEN WILMOT ARE EMPLOYEES OF SHC. MARIANN BYERWALTER, CHRISTOPHER DAWES, JOHN LEVIN, AND LLOYD MINOR ARE DIRECTORS OF SHC. JENNIFER JOHNSON AND MARIANN BYERWALTER HAD A BUSINESS RELATIONSHIP. FORM 990, PART VI, LINE 4 LPCH CHANGED ITS BYLAWS IN SEPTEMBER 2017 TO CREATE A NEW EX-OFFICIO SEAT ON THE BOARD.
MEMBERS	FORM 990, PART VI, LINE 6 STANFORD UNIVERSITY IS THE SOLE MEMBER OF LPCH.
FORM 990, PART VI, LINE 7A	THE BOARD OF TRUSTEES OF THE LELAND STANFORD JUNIOR UNIVERSITY ("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 PROVIDED 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 DOCUMENTS 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, PART VI, LINE 19	Quarterly disclosure information available through Electronic Municipal Market Access (EMMA) system. Annual financial statements are available on Stanford University's website.
RECONCILIATION	FORM 990, PART XI, LINE 9 CHANGE IN VALUE OF BENEFICIAL INTEREST IN REMAINDER TRUSTS 212,299 ADJUSTMENT FOR MINIMUM PENSION AND POST RETIREMENT LIABILITY 1,997,000 TRANSFER TO STANFORD UNIVERSITY AND OTHER (38,754,832) OTHER (1,003) ------------- TOTAL (36,546,536)
FORM 990 PART IX LINE 11G	DESCRIPTION:TEMP LABOR - MEDICAL PHYSICIAN TOTAL FEES:26894006
FORM 990 PART IX LINE 11G	DESCRIPTION:OTHER PROFESSIONAL SERVICE TOTAL FEES:945331
FORM 990 PART IX LINE 11G	DESCRIPTION:OTHER PURCHASED SERVICE TOTAL FEES:XXX-XX-XXXX
FORM 990 PART IX LINE 11G	DESCRIPTION:OTHER MEDICAL SERVICES TOTAL FEES:XXX-XX-XXXX

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2019

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

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)EAST PALO ALTO ACADEMY 475 POPE STREET MENLO PARK,CA94025 20-2699147	EDUCATIONAL	CA	501(C)(3)	2	STANFORD	Yes
(2)HOSPITAL COMMITTEE FOR THE L-P AREAS 1111 E STANLEY BLVD LIVERMORE,CA94550 94-1429628	HOSPITAL	CA	501(C)(3)	3	SHC	Yes
(3)LUCILE PACKARD FOUNDATION FOR CHILDREN'S 400 HAMILTON AVENUE SUITE 340 PALO ALTO,CA94301 77-0440090	HEALTHCARE	CA	501(C)(3)	7	LPCH	Yes
(4)PACKARD CHILDREN'S HEALTH ALLIANCE 725 WELCH ROAD MC5551 PALO ALTO,CA94304 32-0359189	HEALTHCARE	CA	501(C)(3)	3	LPCH	Yes
(5)SHR HOLDINGS INC 485 BROADWAY MAIL CODE 8838 REDWOOD CITY,CA94063 94-3187167	REAL ESTATE	CA	501(C)(25)	N/A	STANFORD	Yes
(6)STANFORD FACULTY CLUB PO BOX 7229 STANFORD,CA94309 94-1187089	FAC INTERACT.	CA	501(C)(7)	N/A	STANFORD	Yes
(7)STANFORD FEDERAL CREDIT UNION 1860 EMBARCADERO RD PALO ALTO,CA94303 94-1492212	CREDIT UNION	CA	501(C)(1)	N/A	STANFORD	Yes
(8)STANFORD HABITAT CONSERVATION BOARD 485 BROADWAY MAIL CODE 8838 REDWOOD CITY,CA94063 46-1882243	CONSERVATION	CA	501(C)(3)	7	STANFORD	Yes
(9)STANFORD HEALTH CARE 300 PASTEUR DRIVE MC 5555 STANFORD,CA94305 94-6174066	HEALTHCARE	CA	501(C)(3)	3	STANFORD	Yes
(10)STANFORD HEALTH CARE ADVANTAGE 1221 BROADWAY 3RD FLOOR OAKLAND,CA94612 46-4071746	HEALTHCARE	CA	501(c)(3)	12A, I	SHC	Yes
(11)STANFORD PROGRAMME (CAPE TOWN) NPC WAVERLY BUSINESS PARK BUILDING 11 CAPE TOWN SF	EDUCATION	SF	501(C)(3)	N/A	STANFORD	Yes
(12)STANFORD UNIVERSITY BOOKSTORE BLDG 60 MAIN QUAD NO 105 STANFORD,CA94305 94-0894150	SUPPORT	CA	501(C)(3)	12A, I	STANFORD	Yes
(13)SU EMP BEN TRUST POST RETEMPYNT BEN 485 BROADWAY MAIL CODE 8838 REDWOOD CITY,CA94063 94-3246199	BENEFITS	CA	501(C)(9)	N/A	STANFORD	Yes
(14)THE DUDLEY E CHAMBERS FOUNDATION JP MORGAN CHASE PO BOX 3038 MILWAUKEE,WI53201 38-6841793	SUPPORT	NY	501(C)(3)	12D, III-O	STANFORD	Yes
(15)THE FREIDENRICH SUPPORT FOUNDATION 485 BROADWAY MAIL CODE 8838 REDWOOD CITY,CA94063 30-0519583	SUPPORT	CA	501(C)(3)	12A, I	STANFORD	Yes
(16)THE HONG KONGSU CHARITABLE TRUST 1401 CAROLINE CENTER 28 PING ROAD CAUSEWAY HK 98-6078093	SUPPORT	HK	501(C)(3)	N/A	STANFORD	Yes
(17)THE STANFORD TRUST 65 HIGH STREET OXFORD OX1 46L UK	SUPPORT	UK	501(C)(3)	N/A	STANFORD	Yes
(18)UNIVERSITY HEALTHCARE ALLIANCE 7999 GATEWAY BLVD STE 300 NEWARK,CA94560 94-3192446	HEALTHCARE	CA	501(C)(3)	3	SHC	Yes
(19)VALLEYCARE MEDICAL FOUNDATION INC 5655 W LAS POSITAS BLVD 220 PLEASANTON,CA94588 26-2593526	SUPPRT SHC-VC	CA	501(C)(3)	10	HOSP CMTE LP	Yes
(20)VALLEYCARE SENIOR HOUSING 1111 E STANLEY BLVD LIVERMORE,CA94550 94-3382224	SR. FACILITY	CA	501(C)(3)	12A, I	HOSP CMTE LP	Yes
(21)THE BRD OF TRUST LELAND STANF JR UNIV 3145 PORTER DRIVE PALO ALTO,CA94304 94-1156365	EDUCATION	CA	501(C)(3)	2	NA		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2019

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 590 MADISON AVENUE 27TH FLOOR NEW YORK,NY10022 81-3083288	INVESTMENTS	DE	N/A
(2) ALBUS SELECT FUND LP 750 MENLO AVENUE MENLO PARK,CA94025 81-2064357	INVESTMENTS	DE	N/A
(3) CANARY SC FUND LP 399 PARK AVENUE NEW YORK,NY10022 47-5662144	INVESTMENTS	DE	N/A
(4) CANARY SC MASTER FUND LP 89 NEXUS WAY CAMANA BAY GRAND CAYMAN KY1-9009 CA 98-1267847	INVESTMENTS	CJ	N/A
(5) CARLSBAD CO-INVEST LP 51 JOHN F KENNEDY PARKWAY SUITE 2 SHORT HILLS,NJ07078 47-1702425	INVESTMENTS	DE	N/A
(6) CEE EQUITY HOLDINGS LP JTC HOUSE 28 ESPLANADE ST HELIER JERSEY JE4 2QP JE	INVESTMENTS	JE	N/A
(7) CLAIRVUE CAPITAL PARTNERS II-TE 1 LP TWO EMBARCADERO CENTER SUITE 480 SAN FRANCISCO,CA94111 80-0909516	INVESTMENTS	DE	N/A
(8) CLAIRVUE CAPITAL PARTNERS II-TE 2 LP TWO EMBARCADERO CENTER SUITE 480 SAN FRANCISCO,CA94111 80-0909556	INVESTMENTS	DE	N/A
(9) EZP OPPORTUNITY LP 635 KNIGHT WAY STANFORD,CA943057297 81-4562962	INVESTMENTS	DE	N/A
(10) FORTRESS IW COINVESTMENT (FUND B) LP 1345 AVE OF THE AMERICAS 45TH FL NEW YORK,NY10105 98-0509639	INVESTMENTS	CJ	N/A
(11) FOUR CROSSINGS INSTITUTIONAL PARTNERS V ONE MARITIME PLAZA SUITE 200 SAN FRANCISCO,CA94111 81-4323705	INVESTMENTS	DE	N/A
(12) FOXLANE LP 410 E WATER STREET SUITE 888 CHARLOTTESVILLE,VA22902 81-3314647	INVESTMENTS	DE	N/A
(13) HHBG-II Investment LP 89 NEXUS WAY CAMANA BAY PO BOX 31 GRAND CAYMAN KY1-9009 CA	INVESTMENTS	CJ	N/A
(14) KEB INVESTORS II LP WASHINGTON MALL STE 304 7 REID ST HAMILTON HM 11 BD	INVESTMENTS	BD	N/A
(15) LSF V DHB HOLDINGS LP 2711 N HASKELL AVE STE 1700 DALLAS,TX75204 27-2858604	INVESTMENTS	DE	N/A
(16) OLIFANT FUND LTD 635 KNIGHT WAY STANFORD,CA94305	INVESTMENTS	CJ	N/A
(17) OUTLAWS CASINO LTD 485 BROADWAY MAIL CODE 8838 REDWOOD CITY,CA94063 84-1457498	HOLDING COMPANY	CO	N/A
(18) PALO ALTO LP 13 CASTLE STREET ST HELIER JERSEY JE 98-1126622	INVESTMENTS	JE	N/A
(19) RMS FOREST GROWTH II LP 31 INVERNESS CENTER PARKWAY STE 36 BIRMINGHAM,AL35242 20-0841908	INVESTMENTS	CA	N/A
(20) SANDOVAL LP 635 KNIGHT WAY STANFORD,CA943057297 37-1873346	INVESTMENTS	DE	N/A
(21) SANDPIPER FUND LP 2000 MCKINNEY AVE STE 2125 DALLAS,TX75201 26-0341626	INVESTMENT	TX	N/A
(22) SAROFIM MULTIFAMILY PARTNERS LP 8115 PRESTON RD ST400 DALLAS,TX75225 20-1929002	RE DEVELOPMENT	TX	N/A
(23) SCP REAL ASSETS FUND (A) LP 2498 SAND HILL RD MENLO PARK,CA94025 20-3949682	INVESTMENTS	DE	N/A
(24) SEQUOIA MFM OPERATING COMPANY LLC 770 WELCH ROAD LPCH- ADMIN MC5551 PALO ALTO,CA94304 47-5060529	MFM PROGRAM	CA	NA	RELATED	1,430,033	414,647		No			No	80.000 %
(25) SIC SNOWCREEK VIII LLC 635 KNIGHT WAY STANFORD,CA94305 27-5431605	RE DEVELOPMENT	CA	N/A
(26) SP SMC PARTNERS LLC PO BOX 5377 NEW YORK,NY10185 47-3103791	INVESTMENTS	DE	N/A
(27) STANFORD EMANUEL RADIATION ONCOLOGY CENT 825 DELBON AV TURLOCK,CA95382 20-8885091	RADIOLOGY	CA	N/A
(28) STANFORD PET-CT LLC 300 PASTEUR DR MC 5555 STANFORD,CA94305 61-1423414	MED. DIAGNOST	CA	N/A
(29) STANFORD-STARTX FUND LLC 485 BROADWAY MAIL CODE 8838 REDWOOD CITY,CA94063 46-4297719	INVESTMENTS	DE	N/A
(30) SUMIT HOLDING INTERNATIONAL LLC 1400 PAGE MILL ROAD MC5713 PALO ALTO,CA94304 26-3934706	HOLDING COMPANY	DE	NA	RELATED	-413,952	12,408,838		No	0		No	18.000 %
(31) TESSERA IONIC LP 635 KNIGHT WAY STANFORD,CA943057297	INVESTMENTS	DE	N/A
(32) VEDA INVESTORS FUND LP ONE FAWCETT PL GREENWICH,CT06830 81-1810345	INVESTMETNS	DE	N/A
(33) VERMILION PEAK MASTER FUND 635 KNIGHT WAY STANFORD,CA943057297	INVESTMENTS	DE	N/A
(34) WINTER ROCK ALTERNATIVE CREDIT MASTER L PO BOX 10008 WILLOW HOUSE CRICKET GRAND CAYMAN KY1-1001 CJ 94-1141686	INVESTMENTS	CJ	N/A
(35) WOLFF REAL ESTATE PARTNERS III A LP 6710 E CAMELBACK ROAD SUITE 100 SCOTTSDALE,AZ85251 47-4780701	INVESTMENTS	DE	N/A

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) ALPINE CHALET INC PO BOX 9988 SOUTH LAKE TAHOE,CA96158 94-1556099	SKI LODGE	CA	NA	C CORP
(2) BIENVILLE ARGENTINA OPPS OFFSHORE FUND 405 LEXINGTON AVE 34TH FLOOR NEW YORK,NY10174	INVESTMENTS	CJ	NA	C CORP
(3) BISHOP ROCK OPPORTUNITY OFFSHORE FUND LT 635 KNIGHT WAY STANFORD,CA94305	INVESTMENTS	CJ	NA	C CORP
(4) BREP VII Alberta Feeder (Offshore) TE7 635 KNIGHT WAY STANFORD,CA94305 98-1066351	INVESTMENTS	CA	NA	C CORP
(5) BREP VII Alberta Feeder (Offshore) TE7- 635 KNIGHT WAY STANFORD,CA94305 98-1066355	INVESTMENTS	CA	NA	C CORP
(6) CANARY SC FUND LTD 89 NEXUS WAY CAYMANA BAY GRAND CAYMAN KY1-9009 CJ 98-1268195	INVESTMENTS	CJ	NA	C CORP
(7) CLAT (16)	CHARITABLE TR	CA	NA	TRUST
(8) CRT (552)	CHARITABLE TR	CA	NA	TRUST
(9) EAST SAIL C/O INTL FS INC IFS COURT TWENTYEIGHT CYBERCITY EBENE MP	INVESTMENTS	MP	NA	C CORP
(10) GAVEA INVESTMENT FUND II-C LP PO BOX 896GT HARBOUR CENTRE GEORGE TOWN CJ 98-0537952	INVESTMENTS	CJ	NA	C CORP
(11) HHBG SF Limited 635 KNIGHT WAY STANFORD,CA94305	REAL ESTATE	CA	NA	C CORP
(12) KAIZEN FUND 2ND FL MIDTOWN PLAZA PO BOX 448 GRAND CAYMAN KY1-1106 CJ	INVESTMENTS	CJ	NA	C CORP
(13) LS ALBERTA III LP C/O JE ROBERT COS 1650 TYSON BLVD MCLEAN,VA22102 98-0493425	INVESTMENTS	CA	NA	C CORP
(14) OTHER (5)	CHARITABLE TR	CA	NA	TRUST
(15) PIF (2)	CHARITABLE TR	CA	NA	TRUST
(16) PROFESSIONAL EXCHANGE ASSURANCE COMPANY 201 MERCHANT STREET SUITE 2400 HONOLULU,HI96813 90-0897686	INSURANCE	HI	NA	C CORP
(17) SBFF LTD PO BOX 1344 GEORGE TOWN KY1-1108 CJ	INVESTMENTS	CJ	NA	C CORP
(18) SEA SMOKE FUND LLC 190 ELGIN AVENUE GEORGE TOWN KY 9005 CJ	INVESTMENTS	DE	NA	C CORP
(19) SEA SMOKE FUND LTD 635 KNIGHT WAY STANFORD,CA943057297	INVESTMENTS	CJ	NA	C CORP
(20) STANFORD (BEIJING) CNSLTNG CO LTD (WFOE) 5275TH FLBLDG CACADEMY SOUTH RD BEIJING CH	EDUCATION	CH	NA	C CORP
(21) STANFORD IN JAPAN GODO KAISHA DOSHISHA UNIVERSITY MEITOKUKAN-NAI KYOTOSHI JA	EDUCATION	JA	NA	C CORP
(22) STANFORD INDIA PVT LTD 333 3RD FLOOR DEVIKA TOWER 6 NEH DELHI IN	EDUCATION	IN	NA	C CORP
(23) STANFORD INTL MEDICAL SERVICES RAK FZE PO BOX 56500 AE	PATIENT SRVC	AE	NA	C CORP
(24) STANFORD MEDICINE INTL (HONG KONG) CO LT 833 CHEUNG SHA WAN ROAD KOWLOON HK	PATIENT SRVC	HK	NA	C CORP
(25) STANFORD SGGS EUROPE INC UGLAND HOUSE S CHURCH ST PO BOX 3 GEORGE TOWN CJ 13-1684331	INVESTMENTS	CJ	NA	C CORP
(26) STANFORD UNIV MED NETWORK RISK AUTHORITY 1400 PAGE MILL RD MSC 5713 PALO ALTO,CA94304 46-1132002	RISK MGMT CON	CA	NA	C CORP	-41,270	1,815,120	18.000 %	Yes
(27) STRUCTURED SERVICING HOLDINGS (OFFSHORE) 87 MARY STREET GEORGE TOWN KY1-9002 CJ	INVESTMENTS	CJ	NA	C CORP
(28) THE RUBRUM FUND PO BOX 309 UGLAND HOUSE GRAND CAYMAN CJ	INVESTMENTS	CJ	NA	C CORP
(29) VERMILION PEAK FUND 635 KNIGHT WAY STANFORD,CA943057297	INVESTMENTS	CJ	NA	C CORP
(30) WINTER ROCK ALTERNATIVE CREDIT I LP PO BOX 10008 WILLOW HOUSE CRICKET GRAND CAYMAN KY1-1001 CJ 98-1140761	INVESTMENTS	CJ	NA	C CORP

Schedule R (Form 990) 2019

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

Yes

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

Yes

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

Yes

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	80,839,614	FMV
(2) STANFORD HOSPITAL AND CLINICS (SHC)	N	39,398,195	FMV
(3) STANFORD HOSPITAL AND CLINICS (SHC)	O	3,576,820	FMV
(4) STANFORD HOSPITAL AND CLINICS (SHC)	P,Q	2,749,203	FMV
(5) STANFORD HOSPITAL AND CLINICS (SHC)	R	2,068,019	FMV
(6) PACKARD CHILDREN'S HEALTH ALLIANCE (PCHA)	O	4,328,280	FMV
(7) PACKARD CHILDREN'S HEALTH ALLIANCE (PCHA)	S	8,000,000	FMV
(8) LUCILE PACKARD FDN FOR CHILDREN'S HEALTH	P,Q	12,717,744	FMV

Schedule R (Form 990) 2019

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) 2019

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 HEALTH CARE IS CALCULATED BASED ON THE RATIO OF DIRECT COST TO CHARGES PLUS NEGOTIATED OVERHEAD. THE SHARED SERVICES WITH STANFORD HEALTH CARE IS A NEGOTIATED FIXED DOLLAR ANNUAL RATE. FOR OTHER SERVICES, PAYMENT IS BASED ON EITHER NEGOTIATED RATE OR CONTRACT AGREEMENT.

Schedule R (Form 990) 2019

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	33
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	23
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	4,854
6	Total number of volunteers (estimate if necessary) .............	6	641
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 39 .........	7b	1,875,837

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	86,837,203	45,167,329
9	Program service revenue (Part VIII, line 2g) .........	1,356,659,880	1,504,350,306
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	25,809,870	19,706,626
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	-3,055,458	-4,385,615
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	1,466,251,495	1,564,838,646
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	799,500	1,304,220
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)	595,142,765	671,258,213
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 12,250,119
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	800,736,324	890,869,457
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,396,678,589	1,563,431,890
19	Revenue less expenses. Subtract line 18 from line 12.......	69,572,906	1,406,756
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	3,373,412,254	3,428,785,066
21	Total liabilities (Part X, line 26).............	1,130,457,062	1,172,985,117
22	Net assets or fund balances. Subtract line 21 from line 20.....	2,242,955,192	2,255,799,949

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 393,598,000 including grants of $ ) (Revenue $ 386,233,000 )
	SEE SCHEDULE O

4b	(Code: ) (Expenses $ 304,289,000 including grants of $ ) (Revenue $ 357,266,000 )
	SEE SCHEDULE O

4c	(Code: ) (Expenses $ 177,385,000 including grants of $ ) (Revenue $ 169,269,000 )
	SEE SCHEDULE O

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 516,130,982 including grants of $ 1,304,220 ) (Revenue $ 591,582,306 )
4e	Total program service expenses1,391,402,982

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	10,305,401	12,345,329	3,472,094

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	498,011
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f	44,669,318

g	Noncash contributions included in lines 1a - 1f:$		1g	3,431,008

h Total. Add lines 1a-1f.......		45,167,329

		Business Code
2a	PATIENT SERVICE	900099	1,104,594,325	1,104,594,325
b	OUTREACH PROGRAMS	900099	15,861,098	15,861,098
c	MEDICARE/MEDICAID	900099	250,504,746	250,504,746
d	PROVIDER FEE	900099	110,999,474	110,999,474
e	REVENUE FROM HEALTH RELATED ACTIVITIES	900099	8,812,657	8,812,657
f	All other program service revenue.		13,578,006	13,578,006
g	Total. Add lines 2a–2f .....		1,504,350,306

3 Investment income (including dividends, interest, and othersimilar amounts) ......			20,713,824			20,713,824
4 Income from investment of tax-exempt bond proceeds			56,800			56,800
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents		2,342,674	6a
b	Less: rental expenses		2,869,588	6b
c	Rental income or (loss)	0	-526,914	6c
d	Net rental income or (loss).......			-526,914			-526,914
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	53,000		7a
b	Less: cost or other basis and sales expenses	1,116,998		7b
c	Gain or (loss)	-1,063,998		7c
d	Net gain or (loss).........			-1,063,998			-1,063,998
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a	0
b	Less: direct expenses ...		8b	0
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a	0
b	Less: direct expenses ...		9b	0
c	Net income or (loss) from gaming activities..			0
10a	Gross sales of inventory, less returns and allowances ..
			10a	0
b	Less: cost of goods sold ..		10b	0
c	Net income or (loss) from sales of inventory..			0
Business Code			Miscellaneous Revenue
11a	CAFETERIA		900099	3,843,566			3,843,566
b	INVESTMENT INCOME FROM RELATED PROGRAM		900099	-12,836,889			-12,836,889
c	PARKING INCOME		900099	268,107			268,107
d	All other revenue ....			4,866,515			4,866,515
e	Total. Add lines 11a–11d ......			-3,858,701
12	Total revenue. See instructions.....			1,564,838,646	1,504,350,306		15,321,011

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	1,304,220	1,304,220
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	0
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............	0
4	Benefits paid to or for members .......	0
5	Compensation of current officers, directors, trustees, and key employees ...........	7,347,292	3,380,021	3,378,215	589,056
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	431,317		431,317
7	Other salaries and wages........	432,929,161	392,347,955	40,581,206
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	41,762,080	37,341,314	4,420,766
9	Other employee benefits .......	153,841,732	139,213,611	14,628,121
10	Payroll taxes ...........	34,946,631	31,484,375	3,462,256
11	Fees for services (non-employees):
a	Management ......	10,270,369	3,607,804	6,662,565
b	Legal .........	2,092,846	5,000	2,087,846
c	Accounting ...........	535,189	55,990	479,199
d	Lobbying ...........	1,402,022	39,022	1,363,000
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)	480,660,149	451,307,566	29,352,583
12	Advertising and promotion ....	14,990,625	14,982,560	8,065
13	Office expenses .......	143,091,680	138,593,271	4,498,409
14	Information technology ......	29,372,026	29,335,596	36,430
15	Royalties ..	0
16	Occupancy ...........	21,816,844	13,095,963	8,720,881
17	Travel ............	1,204,733	849,733	355,000
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	0
20	Interest ...........	14,510,316	14,510,316
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	93,486,355	61,393,788	32,092,567
23	Insurance ...	12,666,672	8,869,895	3,796,777
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	25,851,755	25,851,755
b	UTILITIES	8,239,594	7,490,168	749,426
c	UNCOLLECTIBLES	4,698,074	4,699,060	-986
d	LICENSES & TAXES	2,312,852	1,718,225	594,627
e	All other expenses	23,667,356	9,925,774	2,080,519	11,661,063
25	Total functional expenses. Add lines 1 through 24e	1,563,431,890	1,391,402,982	159,778,789	12,250,119
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 ........			0	1	0
2	Savings and temporary cash investments .........			394,401,289	2	275,988,683
3	Pledges and grants receivable, net ......			122,480,245	3	110,698,080
4	Accounts receivable, net .............			309,875,247	4	334,182,369
5	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
				0	6	0
7	Notes and loans receivable, net ...........			0	7	0
8	Inventories for sale or use ............			7,724,398	8	12,253,390
9	Prepaid expenses and deferred charges ......			11,269,205	9	22,903,011
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	2,420,411,547
b	Less: accumulated depreciation	10b	536,034,510	1,722,452,168	10c	1,884,377,037
11	Investments—publicly traded securities .			72,359,608	11	74,164,817
12	Investments—other securities. See Part IV, line 11 .....			713,749,562	12	724,423,030
13	Investments—program-related. See Part IV, line 11 ..			-20,296,784	13	-40,379,403
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			39,397,316	15	30,174,052
16	Total assets. Add lines 1 through 15 (must equal line 33)...			3,373,412,254	16	3,428,785,066

17	Accounts payable and accrued expenses .....	193,891,413	17	245,365,109
18	Grants payable ...	0	18	0
19	Deferred revenue .........	0	19	0
20	Tax-exempt bond liabilities .........	881,137,366	20	872,674,795
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
		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	55,428,283	25	54,945,213
26	Total liabilities. Add lines 17 through 25..	1,130,457,062	26	1,172,985,117

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........		27
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	2,242,955,192	32	2,255,799,949
33	Total liabilities and net assets/fund balances ........	3,373,412,254	33	3,428,785,066