TY 2021 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/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) David Entwistle...................................................................... DIRECTOR	2.0 ................. 54.65	X					0	4,854,308	409,571
(2) Paul King...................................................................... DIR., PRES & CEO	50.0 ................. 2.3	X	X				2,396,216	0	65,315
(3) Lloyd B Minor MD...................................................................... DIRECTOR	2.0 ................. 52.3	X					0	2,084,693	361,941
(4) Randy Livingston...................................................................... DIRECTOR	2.0 ................. 52.0	X					0	1,473,171	234,774
(5) RICK MAJZUN...................................................................... EVP & COO	50.0 ................. 0.0		X				1,111,420	0	157,738
(6) DENNIS P LUND MD...................................................................... DIRECTOR/CMO	50.0 ................. 1.0	X	X				0	1,007,023	64,374
(7) Dana Haering...................................................................... EVP & CFO	47.0 ................. 3.0		X				982,191	0	67,634
(8) Edward Kopetsky...................................................................... SVP & CIO	50.0 ................. 0.0			X			812,946	0	84,516
(9) Mary Leonard MD...................................................................... DIRECTOR	2.0 ................. 48.3	X					0	843,386	31,403
(10) Clifford Lew...................................................................... VP, Exec Dir - Strategic Plann	50.0 ................. 0.0				X		738,059	0	68,703
(11) HELEN WILMOT...................................................................... SHC VP TRNSTN. & STRAT. SPACE	0.0 ................. 50.0					X	0	683,971	85,611
(12) PATRICK IDEMOTO...................................................................... EVP & CHIEF STRATEGY OFFICER	25.0 ................. 25.0			X			650,887	0	95,517
(13) Lisa Grisim...................................................................... VP & ASSOCIATE CIO	50.0 ................. 0.0				X		616,969	0	119,399
(14) Jesus Cepero...................................................................... SVP - Patient Care Services	50.0 ................. 0.0			X			615,858	0	99,878
(15) JANA UHERKOVA-HALE...................................................................... CLINICAL NURSE, OPERATING ROOM	50.0 ................. 0.0				X		641,146	0	56,490
(16) Rosalina Luna...................................................................... Clinical Nurse IV	50.0 ................. 0.0				X		621,075	0	51,696
(17) MARCIE ATCHISON...................................................................... SVP & CHIEF HR OFFICER	50.0 ................. 0.0				X		554,843	0	103,076

(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/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) JILL ANN SULLIVAN........................................................................ SVP - STRAT SPC PLN & GEN SRVS	50.0 .......................0.0			X		554,706	0	93,974
(19) WILLIAM WILSON JR........................................................................ VP & CHIEF TECHNOLOGY OFFICER	50.0 .......................0.0			X		436,042	0	134,371
(20) GREGORY HOGUE........................................................................ VP, FINANCE	50.0 .......................0.0			X		456,926	0	112,565
(21) MATT PEARSON........................................................................ VP, SHC D&C Prgm Mgmt	50.0 .......................0.0			X		0	483,280	74,527
(22) CAROLYN FORD HEMANN........................................................................ VP, AMBULATORY SERVICES	50.0 .......................0.0				X	421,320	0	96,123
(23) KRISTIN PETERSEN........................................................................ VP PROCED & DIAGNOSTIC SRVCS	50.0 .......................0.0				X	163,890	0	47,120
(24) MICHELE SANCHEZ........................................................................ CORPORATE SECRETARY	50.0 .......................0.0		X			147,146	0	33,298
(25) Cameron D'alpe........................................................................ CAO PHYSICIAN PRAC & CEO PCHA	33.0 .......................17.0				X	120,295	0	30,558
(26) AFIA ASAMOAH........................................................................ DIRECTOR (AS OF 4/1/22)	2.0 .......................0.0	X				0	0	0
(27) Sue Bostrom........................................................................ DIRECTOR	2.0 .......................0.0	X				0	0	0
(28) Mariann Byerwalter........................................................................ VICE CHAIR (UNTIL 12/31/21)	2.0 .......................2.0	X	X			0	0	0
(29) Jeff Chambers........................................................................ CHAIR (UNTIL 12/31/21)	10.0 .......................10.3	X	X			0	0	0
(30) Sierra Clark........................................................................ DIRECTOR	2.0 .......................0.0	X				0	0	0
(31) Jonathan Coslet........................................................................ DIR., CHAIR (AS OF 1/1/22)	10.0 .......................2.3	X	X			0	0	0
(32) J Taylor Crandall........................................................................ DIRECTOR	2.0 .......................0.0	X				0	0	0
(33) Elizabeth Dunlevie........................................................................ DIRECTOR	2.0 .......................0.3	X				0	0	0
(34) Brad Geier........................................................................ DIRECTOR	2.0 .......................0.0	X				0	0	0
(35) Ying-Ying Goh MD........................................................................ DIRECTOR (AS OF 4/1/22)	2.0 .......................0.0	X				0	0	0
(36) MARC JONES........................................................................ DIRECTOR (AS OF 1/1/2022)	2.0 .......................2.0	X				0	0	0
(37) Tonia Karr........................................................................ DIRECTOR	2.0 .......................2.0	X				0	0	0
(38) Frank Lee........................................................................ DIRECTOR (UNTIL 12/31/21)	2.0 .......................0.0	X				0	0	0
(39) John Levin........................................................................ DIRECTOR (UNTIL 12/31/21)	2.0 .......................2.0	X				0	0	0
(40) Steve Luczo........................................................................ DIRECTOR (UNTIL 7/6/22)	2.0 .......................0.0	X				0	0	0
(41) Jennifer Mulloy........................................................................ DIRECTOR	2.0 .......................0.0	X				0	0	0
(42) Anthony Noto........................................................................ DIRECTOR	2.0 .......................0.0	X				0	0	0
(43) MINDY ROGERS........................................................................ DIR, VICE CHAIR (AS OF 1/1/22)	2.0 .......................4.3	X	X			0	0	0
(44) Amit Sinha........................................................................ DIRECTOR	2.0 .......................0.0	X				0	0	0
(45) William Thompson III........................................................................ DIRECTOR	2.0 .......................0.0	X				0	0	0

(A) Name and business address	(B) Description of services	(C) Compensation
STANFORD UNIVERSITY, 450 SERRA MALL PALO ALTO,CA94305	PURCHASED SERVICES	213,960,028
STANFORD HEALTH CARE, 300 PASTEUR DR STANFORD,CA94305	MEDICAL LABORATORY	124,800,000
ALIGHT SOLUTIONS LLC, PO BOX 95135 CHICAGO,IL606945135	EMPLOYEE BENEFIT ADM	30,183,556
AMN HEALTHCARE INC, 12400 HIGH BLUFF DRIVE SAN DIEGO,CA92130	TEMP LABOR SERVICE	10,613,849
KR MENLO PARK LLC, 12200 WEST OLYMPIC BLVD STE 200 LOS ANGELES,CA90064	CONSTRUCTION	9,889,599
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 408

- TIN:

SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
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Attach to Form 990 or Form 990-EZ.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

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).)

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 33 1/3% 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 33 1/3% 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 on 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) 2021

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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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 5 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 2021 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2021. 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—2020. 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—2021. 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—2020. 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) 2021

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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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 on 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 5 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 2021 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2020 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2021 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2020 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2021. 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—2020. 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) 2021

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, 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 lines 3b and 3c 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 box 12a or 12b in Part I, answer lines 4b and 4c 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 lines 5b and 5c 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) .

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

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

Did one or more disqualified persons (as defined on 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 on 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) 2021

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 on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, 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 line 2 above, 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 lines 2a and 2b 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 on line 2a, above 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 lines 3a and 3b 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?If "Yes" or "No", 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) 2021

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 0.015 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 0.035	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) 2021

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	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2021 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2021	(iii) Distributable Amount for 2021
1 Distributable amount for 2021 from Section C, line 6
2 Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2021:
a From 2016.......
b From 2017.......
c From 2018.......
d From 2019.......
e From 2020.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2021 distributable amount
i Carryover from 2016 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2021 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2021 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2021, 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 2021. 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 2022. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2017.....
b Excess from 2018.....
c Excess from 2019.....
d Excess from 2020.....
e Excess from 2021.....

Schedule A (Form 990) (2021)

Schedule A (Form 990) 2021

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) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

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

2021

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) (2021)

Schedule B (Form 990) (2021) 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
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2021)

Schedule B (Form 990) (2021)

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) (2021)

Schedule B (Form 990) (2021)

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) (2021)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990)

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

2021

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.

Cat. No. 50084S

Schedule C (Form 990) 2021

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) 2018	(b) 2019	(c) 2020	(d) 2021	(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) 2021

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

309,619

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

Yes

193,442

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

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

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

503,061

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 FY22, 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 $151,442 (includes dollars allotted for benefits). In addition, in FY22, the hospital had a lobbyist in Washington D.C and a non-lobbyist advocate in Sacramento. THE APPROXIMATE VALUE WAS $42,000. 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 FY22, the approximate amount of dues spent on lobbying purposes was $309,619.

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 FY22, 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 $151,442 (includes dollars allotted for benefits). In addition, in FY22, the hospital had a lobbyist in Washington D.C and a non-lobbyist advocate in Sacramento. THE APPROXIMATE VALUE WAS $42,000. 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 FY22, the approximate amount of dues spent on lobbying purposes was $309,619.

Schedule C (Form 990) 2021

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

2021

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) 2021

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 ....	519,466,000	399,694,000	371,437,000	362,582,000	348,490,000
b	Contributions ...	3,103,000	8,425,000	15,589,000	7,252,000	869,000
c	Net investment earnings, gains, and losses	-17,340,000	130,731,000	30,789,000	18,944,000	29,245,000
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	18,350,000	19,384,000	18,121,000	17,341,000	16,022,000
f	Administrative expenses ....
g	End of year balance ......	486,879,000	519,466,000	399,694,000	371,437,000	362,582,000

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

Board designated or quasi-endowment SchDMd Bullet

1.990 %

Permanent endowment SchDMd Bullet

54.060 %

Term endowment SchDMd Bullet

43.950 %

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 ....	1,897,300,009	436,416,477	1,460,883,532
c	Leasehold improvements	50,906,254	35,460,965	15,445,289
d	Equipment ....	484,281,578	364,929,349	119,352,229
e	Other .....	151,503,202	29,520,452	121,982,750
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				1,741,896,300

Schedule D (Form 990) 2021

Page 3

Part VII

Investments - Other 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 MP	1,041,464,482	F
(B) ASSETS LIMITED AS TO USE, HELD	310	F
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	1,041,464,792

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

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

Part IX

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

(a) Description				(b) Book value
(1)OTHER ASSETS				24,172,806
(2)BENEFICIAL INTEREST IN TRUSTS				15,942,700
(3)RIGHT OF USE LEASE ASSETS				183,866,342
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				223,981,848

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
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	251,346,516
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) 2021

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; AND 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. LPCH ALSO HAS BOARD DESIGNATED FUNDS FUNCTIONING AS AN ENDOWMENT. 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 THE UNIVERSITY, SHC, OR LPCH HAVE ANY UNCERTAIN TAX POSITIONS THAT REQUIRE DISCLOSURE OR ADJUSTMENT TO THE CONSOLIDATED FINANCIAL STATEMENTS.

Schedule D (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

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

Attach to Form 990. Right pointing arrow large image

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

OMB No. 1545-0047

2021

Open to Public Inspection

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

Employer identification number

77-0003859

Part I

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

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

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

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

Yes

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

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

(a) Region		(b) Number of offices in the region	(c) Number of employees, agents, and independent contractors in the region	(d) Activities conducted in region (by type) (such as, fundraising, program services, investments, grants to recipients located in the region)	(e) If activity listed in (d) is a program service, describe specific type of service(s) in the region	(f) Total expenditures for and investments in the region
	Europe (Including Iceland and Greenland)	0	0	Program Services	CONFERENCES & SEMINARS	29,391
















3a	Sub-total ....	0	0			29,391
b	Total from continuation sheets to Part I ...
c	Totals (add lines 3a and 3b)	0	0			29,391

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2021

Schedule F (Form 990) 2021

Page 2

Part II

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

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

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

Schedule F (Form 990) 2021

Schedule F (Form 990) 2021Page 3

Part III

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

Part III can be duplicated if additional space is needed.

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

Schedule F (Form 990) 2021

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2021

Page 5

Part V

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

ReturnReference	Explanation

Schedule F (Form 990) 2021

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

2021

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) . . .		422	1,322,738		1,322,738	0.060 %
b	Medicaid (from Worksheet 3, column a) . . . . .		25,851	677,814,366	463,292,192	214,522,174	9.730 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .		26,273	679,137,104	463,292,192	215,844,912	9.790 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	24	127,390	15,127,433	1,089,486	14,037,947	0.640 %
f	Health professions education (from Worksheet 5) . . .	9	19,649	36,389,931	9,256,911	27,133,020	1.230 %
g	Subsidized health services (from Worksheet 6) . . . .	5	4,069	2,522,837	285,385	2,237,452	0.100 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	6	52,470	1,703,224		1,703,224	0.080 %
j	Total. Other Benefits . .	44	203,578	55,743,425	10,631,782	45,111,643	2.050 %
k	Total. Add lines 7d and 7j .	44	229,851	734,880,529	473,923,974	260,956,555	11.840 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2021

Schedule H (Form 990) 2021

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		100,161	100,161
3	Community support	2	40	3,330,714	3,330,714	0.150 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy	1		434,186	434,186	0.020 %
8	Workforce development	2	22	1,086,773	1,086,773	0.050 %
9	Other
10	Total	6	62	4,951,834	4,951,834	0.220 %

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. ......

4,184,919

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).....

4,108,999

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

10,739,504

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

-6,630,505

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) 2021

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) 2021

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 21

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 21

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) 2021

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) 2021

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) 2021

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) 2021

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'S") VALUES And prioritizes input from persons who represent the broad interests of the community in our Community Health Needs Assessment ("CHNA") process - as outlined below. In addition, in FY22 LPCH maintained close connections to community partners, grant recipients, local leaders and community stakeholders, in order to understand the issues that affect our surrounding communities and their effects on the Social Determinants of Health. Those efforts resulted in a deeper understanding of how the community's needs have changed or deepened over the past year. In fiscal year 2022, in collaboration with local area nonprofit hospital organizations and the San Mateo and Santa Clara County Departments of Public Health, we finalized a CHNA that included three strategies for collecting community input: key informant interviews with health experts and community service leaders, focus groups with residents, and focus groups with professionals who represent and/or serve the community or residents. Individuals representing high-need populations (low-income, marginalized communities, medically underserved, homeless, older adult and youth) were included. The members of the informal CHNA collaborative started planning the 2022 Community Health Needs Assessment in January 2021 and began collecting data in spring 2021. To ensure consistency across each interview and focus group, the study team generated research protocols. This CHNA sought to build on prior CHNAs by focusing the primary research on topics and subpopulations that are less well-understood by the statistical data. For example, the experiences of the Black population in San Mateo and Santa Clara counties are often obscured by statistics that represent an entire county's population rather than the Black population as a particular subgroup. The 2022 study team specifically convened a focus group of Black professionals to better understand through this primary qualitative research. The study team conducted the key informant interviews and focus groups for this assessment and recorded each interview and focus group. Recordings were transcribed and qualitative research software tools were used to analyze the transcripts for common themes. The study group also tabulated how many times health needs were prioritized by each of the focus groups or described as a priority in a key informant interview. The study team used this tabulation to help assess community health priorities. In all, the study teams solicited input from nearly 100 community members, community leaders, and representatives of various organizations and sectors. These representatives work either in the health field or in a community-based organization that focuses on improving health and quality of life conditions by serving those from high-need populations. In March and April 2021, the study team spoke with 15 experts from various organizations in San Mateo and Santa Clara counties. Interviews were conducted virtually via Zoom for approximately one hour. Prior to each interview, participants were asked to complete a short online survey in which they were asked to identify the health needs they felt were the most pressing among the people they served. Interviewees could choose up to three needs from the list of needs presented to them, which had been identified in one or both counties in 2019, or could write in needs that were not on the combined 2019 list. Also in the survey, participants were advised of how their interview data would be used and were asked to consent to be recorded. Finally, participants were offered the option of being listed in the report and were asked to provide some basic demographic information (also optional). The discussions centered around four questions for each health need that was prioritized by interviewees: 1. How do you see this need playing out in the community? 2. Which populations are experiencing inequities with respect to this need? 3. How has this need changed in the past few years; how were things going prior to the pandemic, and how are they going now? 4. What is needed (including models/best practices) to better address this need? Further data regarding this gathered community input is contained in the full CHNA available at https://www.stanfordchildrens.org/content-public/pdf/community-health-asse ssment-2022.pdf Although contact information for the manager of community benefits is included in the community benefits report and on the website, we have not received written comments to date. https://www.stanfordchildrens.org/en/about/government-community/benefits-r eports PART V, SECTION B LINE 6 Lucile Salter Packard Children's Hospital Stanford's most recent Community Health Needs Assessment ("CHNA") was conducted in collaboration with the following hospital facilities and organizations: . El Camino Health . Sutter Health . Stanford Health Care . Samaritan House . Gardner Health Services . Bay Area Community Health Advisory Council
PART V, SECTION B, LINE 11	LPCH selected four health needs identified and prioritized by the community through the CHNA process. LPCH selected community health needs that were prioritized through community input and issue areas that reflect LPCH's mission and expertise. THE FOUR SELECTED HEALTH NEEDS ARE: - BEHAVIORAL HEALTH - ECONOMIC INSECURITY - HEALTH CARE ACCESS AND DELIVERY - MATERNAL AND INFANT HEALTH THE FOLLOWING OUTLINES LPCH'S GOALS, STRATEGIES AND THE ANTICIPATED IMPACT OF OUR EFFORTS AROUND THE SELECTED HEALTH NEEDS. 1. BEHAVIORAL HEALTH 1A. GOALS - PROVIDE HIGH-QUALITY MENTAL HEALTH SERVICES TO YOUTH 1A. STRATEGIES - EXPAND ACCESS TO PROGRAMS AND SERVICES THAT PREVENT POOR MENTAL HEALTH (E.G., MINDFULNESS-BASED STRESS REDUCTION) - EXPAND ACCESS TO PROGRAMS AND SERVICES (INCLUDING SCREENING AND COUNSELING/ THERAPY) THAT ADDRESS STRESS, DEPRESSION, AND SUICIDAL IDEATION,including increasing mental/behavioral health workforce - SUPPORT SCHOOL-BASED INTERVENTIONS, POLICIES, PROGRAMS, AND APPROACHES TO IMPROVE SCHOOL CLIMATE AND PREVENT OR REDUCE BULLYING - SUPPORT PROGRAMS AND POLICIES THAT PREVENT OR REDUCE DOMESTIC VIOLENCE AND INCREASE HEALTHY RELATIONSHIPS, BOTH BETWEEN ADULTS AND CHILDREN AND BETWEEN PEERS - PARTICIPATE IN COLLABORATIVES AND PARTNERSHIPS TO ADDRESS MENTAL HEALTH IN THE COMMUNITY 1A. ANTICIPATED IMPACT - REDUCED BULLYING - IMPROVED ACCESS TO SOCIAL/EMOTIONAL HEALTH PROGRAMS AND SERVICES - INCREASED KNOWLEDGE AMONG YOUTH ABOUT METHODS OF COPING WITH STRESS AND DEPRESSION - INCREASED PROPORTION OF YOUTH SERVED WITH EFFECTIVE SOCIAL/EMOTIONAL HEALTH SERVICES - IMPROVED SOCIAL/EMOTIONAL HEALTH AMONG THOSE SERVED - IMPROVED COPING SKILLS AMONG THOSE SERVED - HEALTHIER RELATIONSHIPS FOR THOSE SERVED - REDUCED DISCIPLINARY ACTIONS (SUSPENSIONS, EXPULSIONS) IN SCHOOLS SERVED - IMPROVED SCHOOL CLIMATE IN SCHOOLS SERVED 1B. GOALS - ADDRESS THE SYSTEMIC/INSTITUTIONAL BARRIERS TO MENTAL HEALTH 1B. STRATEGIES - SUPPORT COLLABORATION AND REFERRALS BETWEEN PRIMARY CARE PROVIDERS, EDUCATIONAL PROFESSIONALS, SOCIAL WORKERS, AND OTHERS, AND MENTAL HEALTH SPECIALISTS (AKA YOUTH MENTAL HEALTH CONTINUUM OF CARE) - SUPPORT COORDINATION OF BEHAVIORAL HEALTH CARE AND PHYSICAL HEALTH CARE, SUCH AS CO-LOCATION OF SERVICES, AND MENTAL/BEHAVIORAL HEALTH PROVIDERS TO SUPPORT CO-LOCATED SERVICES - ADVOCACY FOR MENTAL HEALTH PARITY LEGISLATION 1B. ANTICIPATED IMPACT - AMONG PROVIDERS/PROFESSIONALS, INCREASED KNOWLEDGE OF LOCAL RESOURCES AVAILABLE FOR TREATMENT OF DEPRESSION AND RELATED DISORDERS - GREATER COLLABORATION AND COORDINATION IN PROVIDING MENTAL HEALTH SERVICES TO YOUTH - IMPROVED ACCESS TO COORDINATED SOCIAL/EMOTIONAL HEALTH SERVICES 1C. GOALS - IMPROVE MEDIA LITERACY AMONG YOUTH IN LIGHT OF MENTAL HEALTH 1C. STRATEGIES - SUPPORT INITIATIVES, PROGRAMS, AND SERVICES FOR YOUTH TARGETING MEDIA LITERACY, CRITICAL THINKING, AND THE ROLE OF PEERS 1C. ANTICIPATED IMPACT - GREATER MEDIA LITERACY AMONG THOSE SERVED - INCREASED CRITICAL THINKING ABILITIES AMONG THOSE SERVED - HEALTHIER USE OF SOCIAL MEDIA BY THOSE SERVED - REDUCED IMPACT OF CYBERBULLYING AMONG THOSE SERVED 2. ECONOMIC STABILITY 2A. GOALS - Reduce housing instability among vulnerable community members to support better health outcomes 2A. STRATEGIES - Support efforts to improve equitable access to social services that address housing insecurity and financial instability - Support local homelessness prevention organizations and collaboratives that provide temporary financial assistance, legal support, case management and/or other needed services to low-income individuals and families at risk of losing their housing - Support integrated case management programs that link vulnerable individuals with housing 2A. ANTICIPATED IMPACT - Increased equitable access to social services to prevent homelessness - Increased utilization of social services - Reduced proportion of individuals who are housing insecure - Reduced racial/ethnic disparities in housing instability - Increased housing stability among those served - Increased financial stability among those served - Improved health outcomes among those served 2B. GOALS - Reduce food insecurity among vulnerable community members to support better health outcomes 2B. STRATEGIES - Support efforts to improve equitable access to social services that address food insecurity - Support efforts to increase enrollment in CalFresh/SNAP & WIC - Support efforts to increase equitable utilization of existing food banks and other food distribution sites, - Support improvements in social determinants of health screening and referral systems in hospitals and community clinics - Support healthy food access interventions in communities (e.g., community gardens, farmers markets) - Support opportunities for community health education about nutrition/healthy eating 2B. ANTICIPATED IMPACT - Increased equitable access to social services to reduce food insecurity - Increased utilization of social services - Reduced racial/ethnic disparities in food insecurity - Increased food security among those served - Improved health outcomes among those served 2C. GOALS - Reduce economic instability among vulnerable community members to support better health outcomes 2C. STRATEGIES - Support distribution of "essential resources" to vulnerable community members - Support efforts to increase workforce-related educational attainment and/or job training - Advocacy for Universal Basic Income pilots 2C. ANTICIPATED IMPACT - More families can meet their basic needs - Reduced unemployment rates - Reduced pay disparities - Reduced inequities in educational attainment - Reduced poverty rates 3. ACCESS TO CARE 3A. GOALS - INCREASE AVAILABILITY OF HEALTH CARE SERVICES FOR VULNERABLE CHILDREN, YOUTH, AND YOUNG ADULTS (AGES 0-24) 3A. STRATEGIES - SUPPORT HEALTH CARE CLINICS IN CLOSE GEOGRAPHIC PROXIMITY TO POPULATIONS OF LOW SOCIOECONOMIC STATUS neighborhoods and other neighborhoods where health care disparities exist) - SUPPORT SYSTEMS APPROACHES TO INCREASED ACCESS TO CARE, INCLUDING TELEMEDICINE, AFTER-HOURS AVAILABILITY, ETC. 3A. ANTICIPATED IMPACT - INCREASED NUMBER OF CHILDREN AND EXPECTANT MOTHERS SERVED - INCREASED ACCESS TO PREVENTATIVE MEDICINE - INCREASED EQUITABLE ACCESS TO HEALTH CARE SERVICES - IMPROVED PATIENT RELATIONSHIPS WITH PRIMARY CARE PHYSICIANS - REDUCED UNNECESSARY ED VISITS/HOSPITALIZATIONS - INCREASED VACCINATION RATES - DECREASED OUTBREAKS OF VACCINE PREVENTABLE DISEASES - REDUCED HEALTH INEQUITIES 3B. GOALS - DIRECT PROVISION OF CARE TO VULNERABLE PATIENTS 3B. STRATEGIES - CONTINUE TO PROVIDE UNCOMPENSATED MEDICAL CARE TO MEDICAL PATIENTS - CONTINUE TO PROVIDE CHARITY CARE TO LOW-INCOME PATIENTS 3B. ANTICIPATED IMPACT - INCREASED NUMBER OF CHILDREN AND EXPECTANT MOTHERS SERVED - Increased equitable access to health care services - Reduced health inequities 3C. GOALS - ENSURE FUTURE SUPPLY OF DIVERSE HEALTH CARE PROVIDERS 3C. STRATEGIES - PROVIDE TRAINING TO HEALTH CARE PROFESSIONALS - Support efforts to increase diversity of health care workforce 3C. ANTICIPATED IMPACT - INCREASED NUMBER OF QUALIFIED PROVIDERS IN THE COMMUNITY FOCUSED ON COMMUNITY-BASED PRACTICES - STANDARD OF CARE RAISED - Increased equitable access to health care services 3D. GOALS - ADDRESS SYSTEMIC/INSTITUTIONAL BARRIERS TO ACCESS 3D. STRATEGIES - ADVOCATE FOR HEALTH CARE POLICY CHANGE AT THE LOCAL, STATE, AND FEDERAL LEVELS THAT IMPROVE HEALTH CARE ACCESS FOR VULNERABLE CHILDREN AND FAMILIES 3D. ANTICIPATED IMPACT - SYSTEM-WIDE HEALTH CARE IMPROVEMENTS FOR CHILDREN AND FAMILIES - Increased equitable access to health care services - Reduced health inequities
PART V, SECTION B, LINE 11 (CONTINUED)	4. MATERNAL AND INFANT HEALTH 4A. GOALS - REDUCE THE RATES OF TEEN BIRTHS AND IMPROVE THE LIVES OF TEEN MOTHERS AND THEIR CHILDREN 4A. STRATEGIES - Expand access to teen pregnancy prevention programs among populations with historically high rates of teen pregnancy - EXPAND ACCESS TO DEPRESSION SCREENING PROGRAMS FOR PREGNANT AND NEW TEEN MOTHERS, INDIVIDUAL OR GROUP-BASED PARENTING PROGRAMS, HOME VISITS, AND NURSE/FAMILY PARTNERSHIPS 4A. ANTICIPATED IMPACT - LOWER RATE OF TEEN BIRTHS - REDUCED DISPARITIES IN TEEN BIRTH RATES - IMPROVED MENTAL HEALTH OF PREGNANT TEENS AND TEEN PARENTS 4B. GOALS - INCREASE LEVELS OF ADEQUATE PRENATAL CARE 4B. STRATEGIES - Expand access to enhanced prenatal care programs among Black women and other populations with historical disparities in birth outcomes - Expand access to group prenatal care among Black women and other populations with historical disparities in birth outcomes - Expand community access to prenatal health education 4B. ANTICIPATED IMPACT Among Black women and women from other populations with historical disparities in birth outcomes: - Increased number of pregnant women who benefit from home visits - Improved access to prenatal health education - Higher enrollment in group prenatal care programs - Improved access to prenatal care - More favorable birth outcomes (fewer incidences of low or very low birthweight, preterm or very preterm birth, and infant mortality) 4C. GOALS - Reduce disparities in birth outcomes 4C. STRATEGIES - Expand access to enhanced prenatal care programs among Black women and other populations with historical disparities in birth outcomes - Expand access to group prenatal care among Black women and other populations with historical disparities in birth outcomes - Expand community access to prenatal health education 4C. ANTICIPATED IMPACT - GREATER EQUITY IN BIRTH OUTCOMES 4D. GOALS - REDUCE RISKS OF INJURY TO INFANTS 4D. STRATEGIES - SUPPORT PUBLIC CAMPAIGNS, ADVOCACY, EDUCATION, AND/OR PROGRAMS AIMED AT REDUCING UNINTENTIONAL INJURIES (E.G., SIDS, VEHICULAR ACCIDENTS, FALLS), INCLUDING INFANT CPR - SUPPORT PUBLIC CAMPAIGNS, ADVOCACY, EDUCATION, AND/OR PROGRAMS AIMED AT REDUCING CHILD ABUSE AND NEGLECT, INCLUDING HOME VISITS 4D. ANTICIPATED IMPACT - INCREASED AWARENESS OF INFANT SAFETY - REDUCED NUMBER OF INFANT INJURIES - REDUCED NUMBER OF INFANT DEATHS DUE TO UNINTENTIONAL INJURIES, ABUSE, OR NEGLECT LPCH is dedicated to investing in community-based organizations and programs/services that improve these health needs in the community. These health needs comprise the primary focus of our proactive community benefit work and the grantmaking program. LPCH's community investments will focus primarily on the four community health needs listed above by investing staff time and financial resources into local community-based organizations 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 FOUR PRIORITY AREAS IDENTIFIED BELOW. ALL ELEVEN IDENTIFIED HEALTH NEEDS WILL RECEIVE ATTENTION AND RESOURCES EITHER DIRECTLY OR INDIRECTLY. HEALTH NEEDS NOT SELECTED BY LPCH'S IMPLEMENTATION STRATEGY: LPCH WILL ADDRESS THE FOUR HEALTH NEEDS THAT MET ALL OF THE PRIORITIZATION/SELECTION CRITERIA. LPCH'S WILL NOT ADDRESS THE FOLLOWING IDENTIFIED HEALTH NEEDS: The following health needs were not chosen because the need was not strongly prioritized by the community or because existing programs/resources are available: - Asthma - Climate/Natural Environment - Cancer - Community Safety - Diabetes and Obesity - Unintended Injuries - Sexually Transmitted Infections
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 HTTPS://WWW.STANFORDCHILDRENS.ORG/EN/PATIENT-FAMILY-RESOURCES/FINANCIAL-AS SISTANCE-ENGLISH. IT IS ALSO AVAILABLE ON THE STATEMENTS SENT TO PATIENTS.
PART V, SECTION B, LINE 20A	FINANCIAL ASSISTANCE DISCUSSION OCCURS AT THE TIME OF ADMISSION WHEN THE PATIENT SPEAKS WITH A FINANCIAL COUNSELOR. FINANCIAL ASSISTANCE INFORMATION IS ALSO INCLUDED IN THE ADMISSION PACKETS PROVIDED TO PATIENTS. LPCH WILL PURSUE PAYMENT FOR DEBTS OWED FOR HEALTH CARE SERVICES PROVIDED BY LPCH. ALL PATIENT ACCOUNT BALANCES THAT MEET LPCH CRITERIA FOR ASSIGNMENT TO BAD DEBT ACCORDING TO LPCH POLICY AND PROCEDURES ARE ELIGIBLE FOR PLACEMENT WITH A COLLECTION AGENCY. HOWEVER, LPCH DOES NOT CURRENTLY ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIVITY (ECA).
PART V, SECTION B, LINE 20B & 20C	FINANCIAL ASSISTANCE DISCUSSION MAY ALSO OCCUR AT THE TIME OF DISCHARGE WITH A FINANCIAL COUNSELOR IF THE PATIENT EXPRESSES CONCERN ABOUT FINANCIAL LIABILITY.
PART V, SECTION B, LINES 20D AND 20E	LPCH DID NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIONS IN FY22.

Schedule H (Form 990) 2021

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) 2021

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
SCHEDULE H, PART I, LINE 3C	For Financial Assistance Program, LPCH considers US residency as the criteria for eligibility. For Charity Care, LPCH does not limit it to US residency; international patients could also be eligible. SCHEDULE H, PART I, LINE 6 THE ORGANIZATION PREPARED A COMMUNITY BENEFIT REPORT FOR FISCAL YEAR 2022 AND IT IS AVAILABLE TO THE PUBLIC AT HTTP://WWW.STANFORDCHILDRENS.ORG/EN/ABOUT/GOVERNMENT-COMMUNITY/BENEFITS- REPORTS. SCHEDULE H, PART I, LINE 7, COLUMN F THE AMOUNT OF BAD DEBT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN LINE 7, COLUMN F WAS $18,372,358. SCHEDULE H, 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.
SCHEDULE H, 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.
SCHEDULE H, 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 organization's cost accounting system addresses all patient segments and excludes research and some grant related costs.
SCHEDULE H, PART III, LINE 4	THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT INCLUDE A SPECIFIC FOOTNOTE THAT DESCRIBES PROVISION FOR DOUBTFUL ACCOUNTS. Effective September 1, 2018, LPCH adopted ASU 2014-09, "Revenue from Contracts with Customers" (FASB ASC 606) using a modified retrospective method of application to all contracts existing upon adoption. The most significant impact of adopting the new standard is in the presentation in the consolidated statement of operations and changes in net assets where historical provision for bad debts is now considered an implicit price concession in determining the consideration expected to be paid to LPCH, and is therefore recorded as a direct reduction of patient revenue and patient accounts receivable.
SCHEDULE H, PART III, LINE 8	THE MEDICARE SHORTFALL OF ($6,630,505) 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.
SCHEDULE H, 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.
SCHEDULE H, 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 routinely invests in process improvement, program improvement and strategic planning initiatives that seek to improve the quality and impact of the organization's community investments. LPCH partners with public health experts to evaluate our current efforts and to improve our data collection processes and reporting. These, and other efforts help LPCH better understand the impact of community health improvement efforts on the underserved members of our community. 8) LPCH OFFERS TECHNICAL SUPPORT ASSISTANCE TO ITS community investments grants program member organizations in order to help build organizational sustainability over the long term. 9) IN FY20, LPCH SURVEYED COMMUNITY PARTNERS, GRANTEES, LOCAL LEADERS AND COMMUNITY STAKEHOLDERS IN ORDER TO BETTER UNDERSTAND THE IMPACTS OF COVID-19 AND THE ACCOMPANYING ECONOMIC CHALLENGES. THAT COMMUNITY INPUT HELPED LPCH BUILD A COVID-19 COMMUNITY RESPONSE PLAN THAT FOCUSED ON PROVIDING ESSENTIAL NEEDS SUPPORT TO DISADVANTAGED FAMILIES AND CHILDREN IN OUR COMMUNITY. 10) LPCH MAINTAINs CLOSE RELATIONSHIPS TO COMMUNITY PARTNERS, GRANT RECIPIENTS, LOCAL LEADERS, AND COMMUNITY STAKEHOLDERS IN ORDER TO UNDERSTAND BETTER THE IMPACTS OF COVID-19 AND THE EFFECTS IT HAS HAD ON THE SOCIAL DETERMINANTS OF HEALTH IN OUR COMMUNITY. THOSE EFFORTS RESULTED IN A DEEPER UNDERSTANDING OF HOW THE COMMUNITY'S NEEDS HAVE CHANGED OR DEEPENED OVER THE PAST YEAR. 11) LPCH is focused on numerous health equity initiatives that seek to reduce health disparities in the community. The efforts are focused on adopting a health equity framework for grantmaking, cultural diversity and equity and inclusion training and strategic planning.
SCHEDULE H, 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 ARE 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 PLAIN LANGUAGE SUMMARY, THE UNINSURED PATIENT DISCOUNT POLICY, THE AVAILABILITY OF SUCH ASSISTANCE AND DISCOUNTS, AND A TELEPHONE NUMBER. C. LPCH BILLING STATEMENTS INFORM THE PATIENT THAT FINANCIAL ASSISTANCE IS AVAILABLE BY CONTACTING THE LPCH CUSTOMER SERVICE CENTER.
SCHEDULE H, PART VI, LINE 4	Because of its international reputation for providing outstanding care to babies, children, adolescents, and expectant mothers, LPCH serves patients and their families around the entire San Francisco Bay Area. In the 13-county Northern California region LPCH ranks first for pediatrics, with 10.1 percent market share, and third for obstetrics, with 4.4 percent market share. However, LPCH's 2021 discharge data show that slightly less than half (46.7 percent) of its inpatient pediatric cases (excluding normal newborns) and 81.1 percent of obstetrics cases come from San Mateo and Santa Clara counties. So, for purposes of its community benefit initiatives, LPCH has identified these two counties as its target community. This hospital ranks first in market share (19.9 percent) for pediatrics and second for obstetrics (9.3 percent) in its primary service area. San Mateo County comprises 19 cities and more than two dozen unincorporated towns and areas. It is far less populous than Santa Clara County, with approximately 746,752 residents in 2019. Daly City is San Mateo County's largest city by population, with just over 106,000 people (14% of the total). The population of the county is substantially more dense than the state, with 9,206 people per square mile compared to 8,486 per square mile in California. The median age in San Mateo County is 40.3 years old. Over 20% of the county's residents are under the age of 18, and nearly 16% are 65 years or older. Santa Clara County comprises 18 cities and large areas of unincorporated rural land. In 2019, approximately 1.92 million people lived there, making it the sixth largest county in California by population. San Jose is its largest city, with over 1.02 million people (53% of the total). The population of the county is substantially more dense than the state, with 9,115 people per square mile compared to 8,486 per square mile in California. The median age in Santa Clara County is 38.1 years old. More than 22% of the county's residents are under the age of 18, and over 13% are 65 years or older. In both counties, residents aged 0-14 make up about one fifth of the population, which is similar to the state. The percentage of women aged 15-50 who have given birth is 5 percent in both counties and in California. The ethnic makeup of both counties is extremely diverse. In total, the non-white population of San Mateo County represents about 62% of its total population, while 70% of Santa Clara County's total population is non-white. RACE/ETHNICITY SANTA CLARA COUNTY SAN MATEO COUNTY TOTAL PERCENTAGE OF COUNTY TOTAL PERCENTAGE OF COUNTY AMERICAN INDIAN/ALASKAN NATIVE 0.2 0.1 ASIAN 38.5 30.1 BLACK 2.3 2.2 HISPANIC/LATINX 25.1 24.2 PACIFIC ISLANDER/NATIVE HAWAIIAN 0.3 1.3 WHITE 29.9 37.8 MULTIRACIAL 3.4 4.0 SOME OTHER RACE 0.2 0.4 More than 34% of residents in San Mateo County and more than 39% of residents in Santa Clara County are foreign-born. This percentage is higher than the foreign-born populations statewide (27%) and nationwide (14%). Our communities earn some of the highest annual median incomes in the U.S., but they also bear some of the highest costs of living. Median household incomes are $130,820 in San Mateo County and $129,210 in Santa Clara County, both far higher than California's median of $82,053. Yet the California Self-Sufficiency Standard, set by the Insight Center for Community Economic Development, suggests that many households in San Mateo and Santa Clara counties are unable to meet their basic needs. (The Standard in 2021 for a family with two children, the 2021 standard was $166,257 in San Mateo County and $144,135 in Santa Clara County.) Housing costs are high: In 2021, the median home price was $1.6 million and the median rent was $2,451 in San Mateo County; this compares to $1.4 million and $2,374 in Santa Clara County. In both counties, 26% of children are eligible for free or reduced-price lunch and close to one quarter of children live in single-parent households (22% of children in San Mateo County and 23% of children in Santa Clara County). About 4% of people in our communities are uninsured. The minimum wage in San Mateo County was $14-$15.90 per hour in 2021 and in Santa Clara County was $14-$16.30 per hour, where self-sufficiency requires an estimated $34-$39 per hour. California Self-Sufficiency Standard data show a 26% increase in the cost of living in San Mateo County and a 27% increase in Santa Clara County between 2018 and 2021, while the U.S. Bureau of Labor Statistics reports only a 5.4% per year average increase in wages in the San Jose-Sunnyvale-Santa Clara metropolitan area between 2018 and 2020. Judging by the Neighborhood Deprivation Index, a composite of 13 measures of social determinants of health such as poverty/wealth, education, employment, and housing conditions, both counties' populations overall are healthier than the national average. Although San Mateo and Santa Clara counties are quite diverse and have substantial resources, there is significant inequality in their populations' social determinants of health and health outcomes. For example, the Gini Index, a measure of income inequality, is higher in certain ZIP Codes compared to others. Certain areas also have poorer access to high-speed internet (e.g., ZIP Codes 95013, 94074), walkable neighborhoods (e.g., ZIP Codes 95002, 94060), or jobs (e.g., ZIP Codes 95020, 94044). In our assessment of the health needs in our community, we focus particularly on disparities and inequities within our community rather than simply in comparison to California or the nation as a whole.
SCHEDULE H, 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 FY2022 COMMUNITY BENEFIT REPORT AND FY2023 IMPLEMENTATION PLAN FILED FEBRUARY 2023 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. LPCH FUNDS ONGOING RESEARCH THROUGH STANFORD UNIVERSITY SCHOOL OF MEDICINE THAT SEEKS TO IMPROVE THE HEALTH OF OUR COMMUNITY.
SCHEDULE H, 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) 2021

Additional Data

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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

2021

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) LEGAL AID SOCIETY OF SAN MATEO COUNTY 330 TWIN DOLPHIN DR REDWOOD CITY,CA94065	94-1451894	501(C)(3)	75,000	SUPPORT TO IMPROVE ACCESS TO PRIMARY HEALTHCARE SERVICES
(2) PUENTE DE LA COSTA SUR 620 NORTH STREET PESCADERO,CA94060	37-1484262	501(C)(3)	90,000	SUPPORT TO IMPROVE ACCESS TO PRIMARY HEALTHCARE SERVICES
(3) SANTA CRUZ COMMUNITY HEALTH CENTERS 125 WATER ST STE A-2 SANTA CRUZ,CA95060	23-7428303	501(C)(3)	85,000	SUPPORT TO IMPROVE ACCESS TO PRIMARY HEALTHCARE SERVICES
(4) TEEN SUCCESS INC 508 VALLEY WAY MILPITAS,CA95035	45-0702884	501(C)(3)	50,000	EMPOWERS YOUNG MOTHERS TO GRADUATE HIGH SCHOOL AND BREAK OUT OF THE CYCLE OF POVERTY FOR THEMSELVES AND THEIR CHILDREN
(5) RAVENSWOOD FAMILY HEALTH CENTER 1885 BAY ROAD EAST PALO ALTO,CA94303	94-3372130	501(c)(3)	300,000	TO IMPROVE THE HEALTH STATUS OF THE COMMUNITY BY PROVIDING PREVENTATIVE HEALTH CARE TO PEOPLE OF ALL AGES REGARDLESS OF ABILITY TO PAY
(6) ADOLESCENT COUNSELING SERVICES 643 BAIR ISLAND ROAD STE 301 REDWOOD CITY,CA94063	51-0192551	501(C)(3)	90,000	EMPOWER YOUTH IN OUR COMMUNITY TO FIND THEIR WAY THROUGH SOCIAL-EMOTIONAL SUPPORT AND BY BUILDING SAFE, ACCEPTING COMMUNITIES.
(7) ACKNOWLEDGE ALLIANCE 2483 OLD MIDDLEFIELD WAY STE 201 MOUNTAIN VIEW,CA94043	77-0393676	501(C)(3)	40,000	PROMOTE POSITIVE SCHOOL CLIMATE AND WELL BEING OF STUDENTS BY INCREASING AWARENESS OF SOCIAL AND EMOTIONAL ISSUES AMONG STUDENTS
(8) MY DIGITAL TAT2 INC 190 SOUTHWOOD DR PALO ALTO,CA943013134	81-2905686	501(C)(3)	40,000	EMPOWER STUDENTS, FAMILIES, AND EDUCATORS TO UNDERSTAND THE POWER OF TECHNOLOGY AND THE IMPACT OF THEIR ONLINE PRESENCE
(9) ROOTS COMMUNITY HEALTH CENTER 7272 MACARTHUR BLVD OKLAND,CA946052533	26-2583954	501(C)(3)	50,000	MEDICAL AND BEHAVIOR HEALTHCARE, HEALTH NAVIGATION, WORKFORCE ENTERPRISES, HOUSING, OUTREACH, AND ADVOCACY.
(10) SONRISAS DENTAL HEALTH INC 430 N EL CAMINO REAL SAN MATEO,CA94401	94-3390196	501(C)(3)	40,000	PROVISION OF QUALITY DENTAL CARE AND ORAL HEALTH EDUCATION TO THE COMMUNITY
(11) FRESH APPROACH 5060 COMMERCIAL CIRCLE SUITE C CONCORD,CA94520	26-2438206	501(C)(3)	60,000	create long-term change in local food systems, by connecting California communities with healthy food from California farmers and expanding knowledge about food and nutrition.

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) 2021

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

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 community and 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. Maintenance of Records: LPCH's Government & Community Relations department houses a community benefit operations team that oversees the community investment grantmaking program and coordinates maintenance of records throughout the organization, as they pertain to community benefit. LPCH utilizes multiple tools to maintain the broader grantmaking program, including: a digital grants-management platform, community benefit accounting software, electronic grant award and acceptance documents and multiple financial records housed in LPCH's finance department. Grantee Eligibility: 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. Selection Criteria: 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. LPCH 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 Senior Vice President and Chief Government Relations Officer, conducts oversight of all grantee organizations throughout the grant year. LPCH also provides smaller financial support (less than $25,000) to not-for-profit organizations serving children, adolescents and pregnant women to support their program or to present symposia, seminars or conferences.

Schedule I (Form 990) 2021

Additional Data

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Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

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

OMB No. 1545-0047

2021

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) 2021

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, 1099-MISC compensation, and/or 1099-NEC			(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)
1MARCIE ATCHISON SVP & CHIEF HR OFFICER	(i) (ii)	432,771 ------------- 0	117,408 ------------- 0	4,664 ------------- 0	71,263 ------------- 0	31,813 ------------- 0	657,919 ------------- 0	0 ------------- 0
2Jesus Cepero SVP - Patient Care Services	(i) (ii)	450,004 ------------- 0	93,711 ------------- 0	72,143 ------------- 0	65,001 ------------- 0	34,877 ------------- 0	715,736 ------------- 0	0 ------------- 0
3Cameron D'alpe CAO PHYSICIAN PRAC & CEO PCHA	(i) (ii)	116,592 ------------- 0	750 ------------- 0	2,953 ------------- 0	25,706 ------------- 0	4,852 ------------- 0	150,853 ------------- 0	0 ------------- 0
4David Entwistle DIRECTOR	(i) (ii)	0 ------------- 1,912,080	0 ------------- 1,974,161	0 ------------- 968,067	0 ------------- 357,971	0 ------------- 51,600	0 ------------- 5,263,879	------------- 312,114
5Lisa Grisim VP & ASSOCIATE CIO	(i) (ii)	447,892 ------------- 0	123,463 ------------- 0	45,614 ------------- 0	90,727 ------------- 0	28,672 ------------- 0	736,368 ------------- 0	34,518 ------------- 0
6Dana Haering EVP & CFO	(i) (ii)	659,502 ------------- 0	223,948 ------------- 0	98,741 ------------- 0	49,765 ------------- 0	17,869 ------------- 0	1,049,825 ------------- 0	0 ------------- 0
7GREGORY HOGUE VP, FINANCE	(i) (ii)	315,542 ------------- 0	89,842 ------------- 0	51,542 ------------- 0	72,047 ------------- 0	40,518 ------------- 0	569,491 ------------- 0	20,293 ------------- 0
8PATRICK IDEMOTO EVP & CHIEF STRATEGY OFFICER	(i) (ii)	463,967 ------------- 0	156,987 ------------- 0	29,933 ------------- 0	91,978 ------------- 0	3,539 ------------- 0	746,404 ------------- 0	865 ------------- 0
9Paul King DIR., PRES & CEO	(i) (ii)	1,086,047 ------------- 0	726,359 ------------- 0	583,810 ------------- 0	45,600 ------------- 0	19,715 ------------- 0	2,461,531 ------------- 0	338,450 ------------- 0
10Edward Kopetsky SVP & CIO	(i) (ii)	556,775 ------------- 0	153,747 ------------- 0	102,424 ------------- 0	54,300 ------------- 0	30,216 ------------- 0	897,462 ------------- 0	0 ------------- 0
11Mary Leonard MD DIRECTOR	(i) (ii)	0 ------------- 482,295	0 ------------- 361,091	0 ------------- 0	0 ------------- 29,000	0 ------------- 2,403	0 ------------- 874,789	0 ------------- 0
12Clifford Lew VP, Exec Dir - Strategic Plann	(i) (ii)	297,992 ------------- 0	65,292 ------------- 0	374,775 ------------- 0	30,246 ------------- 0	38,457 ------------- 0	806,762 ------------- 0	44,247 ------------- 0
13Randy Livingston DIRECTOR	(i) (ii)	0 ------------- 752,377	0 ------------- 0	0 ------------- 720,794	0 ------------- 199,667	0 ------------- 35,107	0 ------------- 1,707,945	0 ------------- 333,333
14Rosalina Luna Clinical Nurse IV	(i) (ii)	608,414 ------------- 0	2,250 ------------- 0	10,411 ------------- 0	34,800 ------------- 0	16,896 ------------- 0	672,771 ------------- 0	0 ------------- 0
15DENNIS P LUND MD DIRECTOR/CMO	(i) (ii)	0 ------------- 415,526	0 ------------- 513,385	0 ------------- 78,112	0 ------------- 29,000	0 ------------- 35,374	0 ------------- 1,071,397	0 ------------- 0
16RICK MAJZUN EVP & COO	(i) (ii)	695,733 ------------- 0	235,098 ------------- 0	180,589 ------------- 0	110,436 ------------- 0	47,302 ------------- 0	1,269,158 ------------- 0	21,808 ------------- 0
17Lloyd B Minor MD DIRECTOR	(i) (ii)	0 ------------- 1,724,329	0 ------------- 250,000	0 ------------- 110,364	0 ------------- 329,000	0 ------------- 32,941	0 ------------- 2,446,634	0 ------------- 0
18MATT PEARSON VP, SHC D&C Prgm Mgmt	(i) (ii)	0 ------------- 336,788	0 ------------- 86,563	0 ------------- 59,929	0 ------------- 34,800	0 ------------- 39,727	0 ------------- 557,807	0 ------------- 0
19JILL ANN SULLIVAN SVP - STRAT SPC PLN & GEN SRVS	(i) (ii)	374,966 ------------- 0	104,795 ------------- 0	74,945 ------------- 0	54,300 ------------- 0	39,674 ------------- 0	648,680 ------------- 0	31,329 ------------- 0
20JANA UHERKOVA-HALE CLINICAL NURSE, OPERATING ROOM	(i) (ii)	639,995 ------------- 0	750 ------------- 0	401 ------------- 0	26,955 ------------- 0	29,535 ------------- 0	697,636 ------------- 0	0 ------------- 0
21HELEN WILMOT SHC VP TRNSTN. & STRAT. SPACE	(i) (ii)	0 ------------- 451,047	0 ------------- 132,127	0 ------------- 100,797	0 ------------- 39,450	0 ------------- 46,161	0 ------------- 769,582	0 ------------- 221
22WILLIAM WILSON JR VP & CHIEF TECHNOLOGY OFFICER	(i) (ii)	359,973 ------------- 0	68,453 ------------- 0	7,616 ------------- 0	52,211 ------------- 0	82,160 ------------- 0	570,413 ------------- 0	0 ------------- 0
23MICHELE SANCHEZ CORPORATE SECRETARY	(i) (ii)	146,396 ------------- 0	750 ------------- 0	0 ------------- 0	18,937 ------------- 0	14,361 ------------- 0	180,444 ------------- 0	0 ------------- 0
24KRISTIN PETERSEN VP PROCED & DIAGNOSTIC SRVCS	(i) (ii)	126,826 ------------- 0	0 ------------- 0	37,064 ------------- 0	24,557 ------------- 0	22,563 ------------- 0	211,010 ------------- 0	0 ------------- 0
25CAROLYN FORD HEMANN VP, AMBULATORY SERVICES	(i) (ii)	311,411 ------------- 0	86,976 ------------- 0	22,933 ------------- 0	71,825 ------------- 0	24,298 ------------- 0	517,443 ------------- 0	19,369 ------------- 0

Schedule J (Form 990) 2021

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
SCHEDULE J, PART I, LINE 1A	TAX GROSS-UP PAYMENTS ONE OFFICER, ONE KEY EMPLOYEE, AND ONE HIGHEST COMPENSATED EMPLOYEE RECEIVED LODGING OR RELOCATION BENEFITS. THE VALUE WAS GROSSED UP FOR TAX PURPOSES AND HAS BEEN INCLUDED IN SCHEDULE J, PART II, COLUMN B(III). THREE OFFICERS, FIVE KEY EMPLOYEES, FOUR HIGHEST COMPENSATED EMPLOYEES, AND ONE FORMER KEY EMPLOYEE RECEIVED A YEAR END GIFT OF A COMPANY JACKET. THE VALUE WAS GROSSED UP FOR TAX PURPOSES AND HAS BEEN INCLUDED IN SCHEDULE J, PART II, COLUMN B(III). HOUSING TWO OFFICERS, THREE KEY EMPLOYEES, AND ONE HIGHEST COMPENSATED EMPLOYEE RECEIVED HOUSING AS A TAXABLE BENEFIT and THE AMOUNT HAS BEEN INCLUDED IN SCHEDULE J, PART II, COLUMN B(III).
SCHEDULE J, PART I, LINE 4A	CLIFFORD LEW RECEIVED A SEVERANCE PAYMENT OF $289,693 IN CALENDAR YEAR 2021. THIS PAYMENT IS INCLUDED ON SCHEDULE J, PART II, COLUMN B(III).
SCHEDULE J, PART I, LINE 4B	SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN LPCH and STANFORD HEALTH CARE (SHC) PROVIDES ALL SENIOR EXECUTIVES WITH A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) TO SUPPLEMENT THEIR RETIREMENT BENEFITS. FOR EACH CALENDAR YEAR, A HYPOTHETICAL ACCOUNT IS ESTABLISHED FOR EACH PARTICIPANT AND CREDITED WITH AN AMOUNT EQUAL TO A PERCENTAGE OF BASE SALARY (DEPENDING ON THE INDIVIDUAL'S POSITION) AS OF THE LAST DAY OF EACH QUARTER. THE COMPENSATION COMMITTEE MAY DETERMINE THAT CREDITS SHALL BE MADE IN ADDITION TO THOSE ABOVE IN ITS SOLE DISCRETION. A PARTICIPANT BECOMES VESTED IN EACH CALENDAR YEAR ACCOUNT ON THE FIRST BUSINESS DAY OF JANUARY FOLLOWING THE SECOND CALENDAR YEAR IN WHICH THE ACCOUNT WAS ESTABLISHED (OR, IF LATER, THE DATE ON WHICH THE PARTICIPANT COMPLETES TWO FULL YEARS OF PARTICIPATION). THE PARTICIPANT BECOMES FULLY VESTED IN HIS OR HER ACCOUNTS UNDER THE SERP UPON THE EARLIEST OF (A) DISCHARGE FROM EMPLOYMENT WITHOUT CAUSE; (B) ENTITLEMENT TO LONG-TERM DISABILITY INCOME BENEFITS; (C) ATTAINMENT OF AGE OF 60 WHILE EMPLOYED OR IF LATER, THE PARTICIPANT'S COMPLETION OF TWO FULL YEARS OF PARTICIPATION; (D) COMPLETION OF SEVEN YEARS AS AN ELIGIBLE EMPLOYEE; OR (E) THE DATE OF DEATH, PRIOR TO PAYMENT OR FORFEITURE, WITH BENEFITS PAYABLE TO THE BENEFICIARY. THE FOLLOWING AMOUNTS BECAME VESTED AND WERE PAID TO THE FOLLOWING INDIVIDUALS IN CALENDAR YEAR 2021: EDWARD KOPETSKY 68,671 GREGORY HOGUE 21,301 CAROLYN FORD-HEMANN 20,615 PATRICK IDEMOTO 912 JILL ANN SULLIVAN 63,010 PAUL KING 535,446 DANA HAERING 80,144 LISA GRISIM 36,358 RICK MAJZUN 22,908 CLIFFORD LEW 46,324 HELEN WILMOT 55,169 DAVID ENTWISTLE 323,758 FOR CERTAIN INDIVIDUALS LISTED ON SCHEDULE J, PART II, AMOUNTS CREDITED UNDER THE PLAN ARE INCLUDED ON SCHEDULE J, PART II, COLUMN (C). 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 THE SERP, WHICH WAS DESCRIBED ABOVE UNDER SCHEDULE J, PART I, LINE 4b. 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 (Form 990) 2021

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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

2021

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	13032UYS1	05-17-2022	230,594,375	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 ..................	230,594,375		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 ...............	2,182,084		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 .............	0		206,870,271		113,527,667		227,083,531
11 Other spent proceeds .............	228,412,291		0		91,100,236		0
12 Other unspent proceeds .............	0		0		0		0
13 Year of substantial completion .............			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 2020, a current refunding issue)? ........	X			X		X		X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X	X			X
16 Has the final allocation of proceeds been made? ..........	X		X		X			X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2021

Page 2

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
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

Schedule K (Form 990) 2021

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
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? ........
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)	FOR LEGAL DEFEASANCE AND REDEMPTION OF THE 2012 SERIES A BONDS AND PARTIAL REFUND OF THE 2012 SERIES B 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 C (2016 BONDS)	THE PROCEEDS OF THE 2016 SERIES A BONDS WERE USED TO REFUND, ON ADVANCE BASIS, THE 2008 SERIES BONDS.
SCHEDULE K, PART IV, LINE 2C, COLUMN C (2016 BONDS)	AN ARBITRAGE REBATE ANALYSIS WAS PERFORMED FOR 2016 SERIES A AND B BONDS MARCH 31, 2022. NO PAYMENT WAS DUE TO THE IRS FOR THESE BONDS IN FY2022.
SCHEDULE K, PART IV, LINE 2C, COLUMN D (2017 BONDS)	AN ARBITRAGE REBATE ANALYSIS WAS PERFORMED FOR THE 2017 SERIES A BOND AUGUST 17, 2022. NO PAYMENT WAS DUE TO THE IRS FOR THESE BONDS IN FY2022.

Schedule K (Form 990) 2021

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Schedule L
(Form 990)

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

2021

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
(1) PAUL KING	DIRECTOR & OFFICER	HOUSING LOAN		X	2,150,000	1,750,000		No	Yes		Yes
(2) Jesus Cepero	SVP - Patient Care Services	HOUSING LOAN		X	500,000	500,000		No	Yes		Yes
(3) RICK MAJZUN	COO	HOUSING LOAN		X	1,000,000	987,500		No	Yes		Yes
(4) Greg Hogue	VP - Finance	HOUSING LOAN		X	300,000	300,000		No	Yes		Yes


Total ............... $						3,537,500

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) 2021

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	(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

Part V

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

Return Reference	Explanation

Schedule L (Form 990) 2021

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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

2021

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	55	287,113	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) (2021)

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) (2021)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990)

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

2021

Open to Public
Inspection

Name of the organization

LUCILE SALTER PACKARD CHILDREN'S
HOSPITAL AT STANFORD

Employer identification number

77-0003859

Return Reference	Explanation
FORM 990, PART I, LINE 1 AND FORM 990, PART III, LINE 1	ORGANIZATION'S PRIMARY EXEMPT PURPOSE 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 $544,351,000 GRANTS $0 REVENUE $526,913,000 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 2022, THERE WERE 5,305 OBSTETRIC DISCHARGES FROM THE JOHNSON CENTER AND THE AVERAGE LENGTH OF STAY FOR OBSTETRIC PATIENTS WAS 3.5 DAYS. OBSTETRIC PATIENTS FROM THE PRIMARY SERVICE AREA COUNTIES OF SAN MATEO AND SANTA CLARA ACCOUNTED FOR 82% OF CASES, 15% OF PATIENTS CAME FROM THE SURROUNDING BAY AREA COUNTIES, AND 3% FROM THE REMAINING CALIFORNIA COUNTIES AND OUT OF STATE. NEONATOLOGY SERVED A TOTAL OF 1,231 INPATIENT DISCHARGES IN FISCAL YEAR 2022 WITH AN AVERAGE LENGTH OF STAY OF 15.5 DAYS. OF THESE INPATIENTS, 59% WERE FROM THE PRIMARY SERVICE AREA, 33% FROM THE SURROUNDING BAY AREA COUNTIES, AND 8% FROM THE REMAINING CALIFORNIA COUNTIES AND OUT OF STATE.
FORM 990, PART III, LINE 4B	PROGRAM SERVICE DESCRIPTION MOORE CHILDREN'S HEART CENTER EXPENSE $405,175,000 GRANTS $0 REVENUE $539,843,000 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 THOSE REQUIRING SPECIALIZED CARDIOTHORACIC SERVICES ON A NATIONAL AND INTERNATIONAL BASIS, DRAWING PATIENTS FROM ALL OVER CALIFORNIA, AT LEAST 40 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 FETAL AND PREGNANCY HEALTH PROGRAM. THE NUMBER OF INPATIENTS SERVED BY THE HEART CENTER WAS 903 IN FISCAL YEAR 2022. OF THESE, THERE WERE 25 HEART TRANSPLANTS. THE PROGRAM HAD A CASE MIX INDEX OF 4.7 REFLECTING THE HIGHLY COMPLEX POPULATION THAT WE SERVE. 21% OF PATIENTS CAME FROM OUR PRIMARY SERVICE AREA OF SAN MATEO AND SANTA CLARA COUNTIES, 24% CAME FROM SURROUNDING BAY AREA COUNTIES, 28% CAME FROM OTHER AREAS WITHIN CALIFORNIA, AND 27% FROM OTHER STATES AND BEYOND IN FISCAL YEAR 2022.
FORM 990, PART III, LINE 4C	PROGRAM SERVICE DESCRIPTION BASS CANCER CENTER EXPENSE $267,757,000 GRANTS $0 REVENUE $227,921,000 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 49-bed inpatient unit which opened in December 2019. In the unit, there are 25 Hematology/Oncology beds and 24 Stem Cell Transplant beds. The cancer program also has a 14-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. The program diagnoses and treats approximately 130-190 new cancer patients per year and performed 35 stem cell transplants in fiscal year 2022. 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 2022 totaled 1,128 with an average length of stay of 9.2 days. The Cancer Center is a strong regional program with 37% of patients coming from the primary service area of San Mateo and Santa Clara Counties, 39% from the surrounding Bay Area counties, 17% from other California counties, and 7% from outside the state of California.
FORM 990, PART III, LINE 4D	PROGRAM SERVICE DESCRIPTION OTHER PROGRAMS EXPENSE $825,810,290 GRANTS $1,130,900 REVENUE $897,354,471 IN ADDITION TO THE THREE CENTERS DESCRIBED ABOVE, LPCH PROVIDES CLINICAL SERVICES THROUGH FOUR 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. - Children's Orthopedic and Sports Medicine Center This Center provides fully integrated care for young athletes, from evaluation and diagnosis through individualized treatment plans and follow up. It also helps kids minimize their risk of future injuries and reach their goals by training smarter and safer. The services include a sports nutritionist who can help develop customized nutrition and hydration plans for young athletes. 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's currently sponsors 39 residency/fellowship programs approved by the Accreditation Council for Graduate Medical Education and over 257 enrolled residents and fellows (stated in full time equivalents). Residency programs in pharmacy, social work, hospital chaplaincy, and nursing are also provided. Lucile Packard Children's Hospital partners with Stanford School of Medicine to conduct research in all seven Centers of Emphasis described above. LUCILE SALTER PACKARD CHILDREN'S HOSPITAL AT STANFORD IS ALSO COMMITTED TO ADVOCACY AND COMMUNITY OUTREACH TO IMPROVE THE HEALTH STATUS OF CHILDREN AND PREGNANT WOMEN BY DEVELOPING AND SUPPORTING INNOVATIVE PROGRAMS (WITHIN ITS PRIMARY SERVICE AREAS OF SAN MATEO AND SANTA CLARA, AS WELL AS SANTA CRUZ, MONTEREY, ALAMEDA, SAN FRANCISCO, AND CONTRA COSTA COUNTIES) TO ENHANCE ITS OWN AND THE COMMUNITY'S CAPACITY TO CARE FOR CHILDREN AND PREGNANT WOMEN. THESE PROGRAMS INCLUDE: - MOBILE ADOLESCENT HEALTH SERVICES - Teen Van - CHILD SAFETY PROGRAMS - CARE-A-VAN FOR KIDS - COMMUNITY HEALTH EDUCATION PROGRAMS - Hospital Educational Advocacy Liaisons - Hospital School - Housing Support - Center for Youth Mental Wellness - RESIDENT PHYSICIANS, FELLOWS, MEDICAL STUDENT EDUCATION COSTS (EXCLUDES FEDERAL CHILDREN'S HOSPITALS GRADUATE MEDICAL EDUCATION [CHGME] REIMBURSEMENT) - NURSE AND ALLIED HEALTH PROFESSIONALS TRAINING - Pediatric Advocacy Program - Perinatal Outreach and Consultation Services - Pediatric Weight Control Program - COMMUNITY CLINIC CAPACITY BUILDING AND SUPPORT - Nonprofit sponsorship support - Community Health Improvement Grants - Practical Assistance for Families - Suspected Child Abuse and Neglect Services - Care Coordination Liaisons - Project Safety Net & Health Care Alliance for Response to Adolescent Depression - Child Life and Creative Arts - Center for Youth Mental Wellness - Advocacy for children's health issues - Marguerite Shuttle - Economic development activities - Revive - Service club activities - Support for community emergency management - Workforce development efforts 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.
FORM 990, PART VI, LINE 1A	EXECUTIVE COMMITTEE 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 FIVE (5) OF THE CHAIR OF THE BOARD, A VICE CHAIR, THE DEAN OF THE STANFORD UNIVERSITY SCHOOL OF MEDICINE, THE PRESIDENT OF THE CORPORATION, AND THE CHAIR OF THE AUDIT AND COMPLIANCE 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 FIVE (5) DIRECTORS ACTING AS A COMMITTEE OF THE BOARD OF DIRECTORS, ARE AUTHORIZED JOINTLY TO TAKE WHATEVER ACTION IS NECESSARY TO RESOLVE THE MATTER, AND SUCH ACTION WILL CONSTITUTE AUTHORIZED ACTION OF THE BOARD TO THE SAME EXTENT AS IF IT HAS BEEN ADOPTED AT A MEETING OF THE BOARD; PROVIDED, HOWEVER, THAT AT LEAST ONE (1) OF THE FOUR (4) DIRECTORS ACTING AS A COMMITTEE OF THE BOARD PURSUANT TO THIS SECTION 4.06 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.
FORM 990, PART VI, LINE 2	MEMBERS LLOYD MINOR, DENNIS LUND, MARY LEONARD, AND RANDY LIVINGSTON ARE EMPLOYEES OF STANFORD UNIVERSITY. LLOYD MINOR IS THE DEAN OF THE STANFORD SCHOOL OF MEDICINE. MINDY ROGERS, MARC JONES, AND TONIA KARR ARE TRUSTEES OF STANFORD UNIVERSITY. DAVID ENTWISTLE IS PRESIDENT AND CEO OF SHC. MARIANN BYERWALTER, JEFF CHAMBERS, DAVID ENTWISTLE, JOHN LEVIN, LLOYD MINOR, PAUL KING, RANDY LIVINGSTON, JONATHAN COSLET, MARC JONES, AND MINDY ROGERS ARE DIRECTORS OF SHC. J TAYLOR CRANDALL AND STEVE LUCZO HAVE A BUSINESS RELATIONSHIP.
FORM 990, PART VI, LINE 4	THE BOARD OF DIRECTORS OF LPCH ADOPTED THE FOLLOWING RESOLUTION: IN ACCORDANCE WITH THE BYLAWS, THE CHIEF OPERATING OFFICER IS DULY APPOINTED AS AN OFFICER OF THE CORPORATION FOR THE PURPOSE OF THE SIGNING OF INSTRUMENTS AND CERTIFICATES ON BEHALF OF THE CORPORATION, AMONG OTHER POWERS AND DUTIES AS THE PRESIDENT OF THE CORPORATION SHALL DEEM PROPER.
FORM 990, PART VI, LINE 6	STANFORD UNIVERSITY IS THE SOLE MEMBER 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.
FORM 990, PART VI, LINE 11	PROCEDURES FOR REVIEWING FORM 990 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.
FORM 990, PART VI, LINE 12C	PROCEDURES FOR MONITORING AND ENFORCING COMPLIANCE WITH CONFLICT-OF-INTEREST POLICY OFFICERS, DIRECTORS, AND EMPLOYEES ARE REQUIRED TO COMPLETE AN INITIAL CONFLICT-OF-INTEREST DISCLOSURE STATEMENT ("DISCLOSURE STATEMENT") WITHIN 30 DAYS OF HIRE DATE, REHIRE DATE, OR DATE OF PROMOTION/TRANSFER TO A MANAGEMENT POSITION. ADDITIONALLY, AN UPDATED DISCLOSURE STATEMENT IS REQUIRED THEREAFTER ON AN ANNUAL BASIS (NORMALLY DUE BY MARCH 31ST.) 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 MUTUALLY AGREEABLE PLAN WITH THE SENIOR 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.
FORM 990, PART VI, LINE 15	PROCEDURES FOR DETERMINING COMPENSATION 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 ANNUALLY PRIOR TO ANNUAL INCREASE 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	ANNUAL AND QUARTERLY DISCLOSURE INFORMATION AVAILABLE THROUGH ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) SYSTEM.
FORM 990, PART XI, LINE 9	RECONCILIATION GAIN ON EXTINGUISHMENT OF LONG-TERM DEBT $6,947,008 VALUE CHANGE OF BENEFICIAL INTEREST IN REMAINDER TRUSTS (3,669,753) ADJUSTMENT FOR MINIMUM PENSION AND POST RETIREMENT LIABILITY 1,897,000 TRANSFERS TO STANFORD UNIVERSITY AND OTHER (69,878,748) -------------- TOTAL $(64,704,493)
FORM 990 PART IX LINE 11G	DESCRIPTION:TEMP LABOR - MEDICAL PHYSICIAN TOTAL FEES:95345629
FORM 990 PART IX LINE 11G	DESCRIPTION:OTHER PROFESSIONAL SERVICE TOTAL FEES:545870
FORM 990 PART IX LINE 11G	DESCRIPTION:OTHER PURCHASED SERVICES 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) 2021

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

2021

Open to Public Inspection

Name of the organization

LUCILE SALTER PACKARD CHILDREN'S
HOSPITAL AT STANFORD

Employer identification number

77-0003859

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)THE BRD OF TRUST LELAND STANF JR UNIV 485 BROADWAY MAILCODE 8838 REDWOOD CITY,CA94063 94-1156365	EDUCATION	CA	501(C)(3)	2	NA		No
(2)FUNDACION STANFORD UNIVERSITY EN CHILE AV CONDELL 189 PROVIDENCIA SANTIAGO CI	EDUCATION	CI	501(C)(3)		STANFORD	Yes
(3)STANFORD HEALTH CARE TRI-VALLEY 1111 E STANLEY BLVD LIVERMORE,CA94550 94-1429628	HOSPITAL	CA	501(C)(3)	3	SHC	Yes
(4)JAEDAN BUPIN STANFORD CENTER IN THE REPU	RESEARCH	KR	501(C)(3)	N/A	Stanford	Yes
(5)LUCILE PACKARD FOUNDATION FOR CHILDREN'S 400 HAMILTON AVENUE SUITE 340 PALO ALTO,CA94301 77-0440090	HEALTHCARE	CA	501(C)(3)	7	LPCH	Yes
(6)PACKARD CHILDREN'S HEALTH ALLIANCE 725 WELCH ROAD MC5551 PALO ALTO,CA94304 32-0359189	HEALTHCARE	CA	501(C)(3)	3	LPCH	Yes
(7)SHR HOLDINGS INC 485 BROADWAY MAILCODE 8838 REDWOOD CITY,CA94063 94-3187167	REAL ESTATE	CA	501(C)(25)	N/A	STANFORD	Yes
(8)STANFORD FACULTY CLUB PO BOX 7229 STANFORD,CA94309 94-1187089	FAC INTERACT.	CA	501(C)(7)	N/A	STANFORD	Yes
(9)STANFORD FEDERAL CREDIT UNION 1860 EMBARCADERO RD PALO ALTO,CA94303 94-1492212	CREDIT UNION	CA	501(C)(1)	N/A	STANFORD	Yes
(10)STANFORD HABITAT CONSERVATION BOARD 415 BROADWAY REDWOOD CITY,CA94063 46-1882243	CONSERVATION	CA	501(C)(3)	7	STANFORD	Yes
(11)STANFORD HEALTH CARE 300 PASTEUR DRIVE MC 5555 STANFORD,CA94305 94-6174066	HEALTHCARE	CA	501(C)(3)	3	STANFORD	Yes
(12)STANFORD PROGRAMME (CAPE TOWN) NPC WAVERLY BUSINESS PARK BLDG 11 CAPE TOWN SF	EDUCATION	SF	501(C)(3)	N/A	STANFORD	Yes
(13)STANFORD UNIVERSITY BOOKSTORE BLDG 60 MAIN QUAD NO 105 STANFORD,CA94305 94-0894150	SUPPORT	CA	501(C)(3)	12A, I	STANFORD	Yes
(14)SU EMP BEN TRUST POST RETEMPYNT BEN 485 BROADWAY MAILCODE 8838 REDWOOD CITY,CA94063 94-3246199	BENEFITS	CA	501(C)(9)	N/A	STANFORD	Yes
(15)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
(16)THE FREIDENRICH SUPPORT FOUNDATION 485 BROADWAY MAILCODE 8838 REDWOOD CITY,CA94063 30-0519583	SUPPORT	CA	501(C)(3)	12A, I	STANFORD	Yes
(17)THE HONG KONGSU CHARITABLE TRUST 1401 CAROLINE CENTER 28 PING ROAD CAUSEWAY HK 98-6078093	SUPPORT	HK	501(C)(3)	N/A	STANFORD	Yes
(18)THE STANFORD TRUST 65 HIGH STREET OXFORD OX1 46L UK	SUPPORT	UK	501(C)(3)	N/A	STANFORD	Yes
(19)UNIVERSITY HEALTHCARE ALLIANCE 7999 GATEWAY BLVD STE 300 NEWARK,CA94560 94-3192446	HEALTHCARE	CA	501(C)(3)	3	SHC	Yes
(20)VALLEYCARE MEDICAL FOUNDATION INC 1111 E STANLEY BLVD LIVERMORE,CA94550 26-2593526	SR. FACILITY	CA	501(C)(3)	PF	SHC-TV	Yes
(21)VALLEYCARE SENIOR HOUSING 1111 E STANLEY BLVD LIVERMORE,CA94550 94-3382224	SR. FACILITY	CA	501(C)(3)	12A, I	SHC-TV	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2021

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	(k) Percentage ownership
(1) ADOM PARTNERS LP 1350 6TH AVE 2910 NEW YORK,NY10019 81-3083288	INVESTMENTS	DE	NA
(2) ALBUS SELECT FUND LP 750 MENLO AVE 380 MENLO PARK,CA94025 81-2064357	INVESTMENTS	DE	NA
(3) ARCOLA VENTURE LLC 7121 FAIRWAY DRIVE 410 PALM BEACH GARDENS,FL33418 37-1689632	REAL ESTATE	DE	NA
(4) CANARY SC FUND LP 65 E 55TH ST 35TH FLOOR NEW YORK,NY10022 47-5662144	INVESTMENTS	DE	NA
(5) CANARY SC MASTER FUND LP 89 NEXUS WAY CAMANA BAY GRAND CAYMAN KY1-9009 CJ 98-1267847	INVESTMENTS	CJ	NA
(6) CARLSBAD CO-INVEST LP 40 BEECHWOOD RD SUMMIT,NJ07901 47-1702425	INVESTMENTS	DE	NA
(7) CERASUS FUND II CAYMAN LP 190 ELGIN AVENUE GEORGE TOWN GRAND CAYMAN KY1-9008 CJ	INVESTMENTS	CJ	NA
(8) CHP GTS BLOCKER HOLDINGS A LP 888 BOYLSTON STREET 1410 BOSTON,MA02199 83-0881152	INVESTMENTS	DE	NA
(9) CYPRESS MARINA HEIGHTS LLC 635 KNIGHT WAY STANFORD,CA94305 95-4887979	INVESTMENTS	CA	NA
(10) DGD INVESTMENT LP 190 ELGIN AVENUE GEORGE TOWN GRAND CAYMAN KY1-9008 CJ	INVESTMENTS	CJ	NA
(11) EAGLE ROCK LI HOLDINGS II LLC 1670 OLD COUNTRY RD 227 PLAINVIEW,NY11803 27-1694413	INVESTMENTS	DE	NA
(12) EDEN RADIATION THERAPY SERVICES LLC 300 PASTEUR DRIVE STANFORD,CA94304	HEALTHCARE	CA	NA
(13) ER-S JV LLC 1670 OLD COUNTRY RD 227 PLAINVIEW,NY11803 83-4068077	INVESTMENTS	DE	NA
(14) ER-S JV II LLC 1670 OLD COUNTRY RD 227 PLAINVIEW,NY11803	INVESTMENTS	DE	NA
(15) ER-S INVESTOR LLC 1670 OLD COUNTRY RD 227 PLAINVIEW,NY11803 83-4068357	INVESTMENTS	DE	NA
(16) ER-S INVESTOR II LLC 1670 OLD COUNTRY RD 227 PLAINVIEW,NY11803	INVESTMENTS	DE	NA
(17) ER PROPERTIES FUND LLC 1670 OLD COUNTRY RD 227 PLAINVIEW,NY11803 83-4260396	INVESTMENTS	DE	NA
(18) ER PROPERTIES FUND II LLC 1670 OLD COUNTRY RD 227 PLAINVIEW,NY11803	INVESTMENTS	DE	NA
(19) EZP OPPORTUNITY LP 160 BOVET RD STE 300 SAN MATEO,CA94402 81-4562962	INVESTMENTS	DE	NA
(20) FORTRESS IW COINVESTMENT (FUND B) LP 1345 AVE OF THE AMERICAS 46FL NEW YORK,NY10105 98-0509639	INVESTMENTS	CJ	NA
(21) FOUR CROSSINGS INSTITUTIONAL PARTNERS V ONE MARITIME PLAZA 2100 SAN FRANCISCO,CA94111 81-4323705	INVESTMENTS	DE	NA
(22) FOXLANE LP 550 E WATER ST 888 CHARLOTTESVILLE,VA22902 81-3314647	INVESTMENTS	DE	NA
(23) HHBG-II INVESTMENT LP 89 NEXUS WAY CAMANA BAY PO BOX 31 GRAND CAYMAN KY1-1205 CJ	INVESTMENTS	CJ	NA
(24) KEB INVESTORS II LP WASHINGTON MALL STE 304 7 REID ST HAMILTON,BDHM 11 BD	INVESTMENTS	BD	NA
(25) KF VERMILLION FUND LP 65 EAST 55TH STREET 35TH FLOOR NEW YORK,NY10022	INVESTMENTS	DE	NA
(26) LSF V DHB HOLDINGS LP 2711 N HASKELL AVE 1700 DALLAS,TX75204 27-2858604	INVESTMENTS	DE	NA
(27) OLIFANT FUND LTD SUITE 5B201 2ND FL ONE NEXUS WAY GRAND CAYMAN KY1-1108 CJ 98-0404442	INVESTMENTS	CJ	NA
(28) ONCOLOGY SOLUTIONS VENTURE LLC 300 PASTEUR DRIVE STANFORD,CA94304 86-3250041	HEALTHCARE	CA	NA
(29) OUTLAWS CASINO LTD 415 BROADWAY REDWOOD CITY,CA94063 84-1457498	HOLDING COMPANY	CO	NA
(30) PALO ALTO LP 13 CASTLE STREET ST HELIER JERSEY,JE JE 98-1126622	INVESTMENTS	JE	NA
(31) SANDOVAL LP 4640 ADMIRALTY WAY 5TH FL MARINA DEL REY,CA90292 37-1873346	INVESTMENTS	CA	NA
(32) SANDPIPER FUND LP 2000 MCKINNEY AVE STE 2125 DALLAS,TX75201 26-0341626	INVESTMENT	TX	NA
(33) SAROFIM MULTIFAMILY PARTNERS LP 2525 MCKINNON STREET STE 530 DALLAS,TX75201 20-1929002	RE DEVELOPMENT	TX	NA
(34) SCP REAL ASSETS FUND (A) LP 2498 SAND HILL RD MENLO PARK,CA94025 20-3949682	INVESTMENTS	DE	NA
(35) SEQUOIA MFM OPERATING COMPANY LLC 770 WELCH ROAD LPCH PALO ALTO,CA94304 47-5060529	MFM PROGRAM	CA	NA	RELATED	1,888,383	2,771,031	Yes		0	Yes		66.760 %
(36) SP SMC PARTNERS LLC PO BOX 5377 NEW YORK,NY10185 47-3103791	INVESTMENTS	DE	NA
(37) STANFORD EMANUEL RADIATION ONCOLOGY CENT 825 DELBON AV TURLOCK,CA95382 20-8885091	RADIOLOGY	CA	NA
(38) STANFORD PET-CT LLC 300 PASTEUR DR STANFORD,CA94305 61-1423414	MED. DIAGNOST	CA	NA
(39) STANFORD-STARTX FUND LLC 485 BROADWAY REDWOOD CITY,CA94063 46-4297719	INVESTMENTS	DE	NA
(40) SUMIT HOLDING INTERNATIONAL LLC 1400 PAGE MILL RD PALO ALTO,CA94304 26-3934706	HOLDING COMPANY	DE	NA	RELATED	-71,669	20,997,135	Yes		0		No	18.000 %
(41) SV4 EQUITY LLC 1209 ORANGE STREET WILMINGTON,DE19802	INVESTMENTS	DE	NA
(42) TESSERA IONIC LP PO BOX 194170 SAN FRANCISCO,CA941194170 83-0896257	INVESTMENTS	DE	NA
(43) VEDA INVESTORS FUND LP ONE FAWCETT PL GREENWICH,CT06830 81-1810345	INVESTMENTS	DE	NA
(44) VERMILION PEAK MASTER FUND PO BOX 309 UGLAND HOUSE GRAND CAYMAN KY1-1104 CJ 98-1327671	INVESTMENTS	CJ	NA
(45) WREP III A LP 6710 E CAMELBACK RD 100 SCOTTSDALE,AZ85251 47-4780701	INVESTMENTS	DE	NA

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	Yes	No
(1) BREP VII ALBERTA FDR (OFFSHORE) TE7 LP 345 PARK AVENUE NEW YORK,NY10154 98-1066351	INVESTMENTS	CA	NA	C CORP
(2) BREP VII ALBERTA FDR (OFFSHORE) TE7-NQ 345 PARK AVENUE NEW YORK,NY10154 98-1066355	INVESTMENTS	CA	NA	C CORP
(3) CANARY SC FUND LTD 89 NEXUS WAY CAYMANA BAY GRAND CAYMAN KY1-9009 CJ 92-1268195	INVESTMENTS	CJ	NA	C CORP
(4) CLAT (14)	CHARITABLE TR	CA	NA	TRUST
(5) CLUT (2)	CHARITABLE TR	CA	NA	TRUST
(6) CRT (559)	CHARITABLE TR	CA	NA	TRUST
(7) EAST SAIL C/O INTL FS INC IFS COURT TWENTYEIGHT CYBERCITY EBENE MP	INVESTMENTS	MP	NA	C CORP
(8) ER-S REIT LLC 1670 OLD COUNTRY RD 227 PLAINVIEW,NY11803 83-4068725	INVESTMENTS	DE	NA	C CORP
(9) ER-S REIT II LLC 1670 OLD COUNTRY RD 227 PLAINVIEW,NY11803 88-2004082	INVESTMENTS	DE	NA	C CORP
(10) GAVEA INVESTMENT FUND II-C LP PO BOX 309 UGLAND HOUSE GRAND CAYMAN KY1-1104 CJ 98-0537952	INVESTMENTS	CJ	NA	C CORP
(11) HHBG SF LIMITED 89 NEXUS WAY CAYMANA BAY GRAND CAYMAN KY1-1205 CJ	INVESTMENTS	CJ	NA	C CORP
(12) KAIZEN FUND PO BOX 448 GRAND CAYMAN KY1-1106 CJ	INVESTMENTS	CJ	NA	C CORP
(13) LS ALBERTA III LP C/O LASALLE INV MGMT ONE CURZON ST LONDON W1J 5HD UK	INVESTMENTS	UK	NA	C CORP
(14) OTHER (4)	CHARITABLE TR	CA	NA	TRUST
(15) PIF (2)	CHARITABLE TR	CA	NA	TRUST
(16) PEPPERTREE CAPITAL CAYMAN ISLAND FUND LP 57 E WASHINGTON STREET CHAGRIN FALLS,OH44022 98-1235268	INVESTMENTS	CJ	NA	C CORP
(17) PROFESSIONAL EXCHANGE ASSURANCE COMPANY 201 MERCHANT STREET SUITE 2400 HONOLULU,HI96813 90-0897686	INSURANCE	HI	NA	C CORP
(18) SBFF LTD SUITE 5B201 2ND FL ONE NEXUS WAY GRAND CAYMAN KY1-1108 CJ	INVESTMENTS	CJ	NA	C CORP
(19) SOLKATT LIMITED 190 ELGIN AVENUE GEORGE TOWN GRAND CAYMAN KY1-9008 CJ	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 MEDICINE INTL (HONG KONG) CO LT 833 CHEUNG SHA WAN ROAD KOWLOON HK	PATIENT SRVC	HK	NA	C CORP
(24) STANFORD UNIV MED NETWORK RISK AUTHORITY 1400 PAGE MILL RD MSC 5713 PALO ALTO,CA94304 46-1132002	RISK MGMT CON	CA	NA	C CORP	-24,712	19,380	18.000 %	Yes
(25) THE RUBRUM FUND 7 CLIFFORD STREET LONDON W1S 2FT UK	INVESTMENTS	UK	NA	C CORP
(26) TVC MATSU FUND 89 NEXUS WAY CAYMANA BAY GRAND CAYMAN KY1-9009 CJ	INVESTMENTS	CJ	NA	C CORP
(27) VERMILION PEAK FUND PO BOX 309 UGLAND HOUSE GRAND CAYMAN KY1-1104 CJ 98-1333885	INVESTMENTS	CJ	NA	C CORP
(28) WOODBOURNE CANADA PARTNERS II - CAYMAN 190 ELGIN AVE GRAND CAYMAN KY1-9005 CJ 98-0705321	INVESTMENTS	CJ	NA	C CORP

Schedule R (Form 990) 2021

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

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 Health Care (SHC)	L,M	88,577,659	FMV
(2) Stanford Health Care (SHC)	N	40,411,994	FMV
(3) Stanford Health Care (SHC)	O	3,804,176
(4) Stanford Health Care (SHC)	P,Q	6,055,262	FMV

Schedule R (Form 990) 2021

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?		(k) Percentage ownership
(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	(k) Percentage ownership

Schedule R (Form 990) 2021

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 1	POOLED INVESTMENT FUNDS ARE PRINCIPALLY DOMICILED IN CALIFORNIA.
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 (Form 990) 2021

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	21
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	15
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	6,365
6	Total number of volunteers (estimate if necessary) .............	6	388
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	79,787,887	174,729,856
9	Program service revenue (Part VIII, line 2g) .........	2,105,296,006	2,192,031,471
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	23,551,178	27,650,560
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	4,427,090	2,560,990
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	2,213,062,161	2,396,972,877
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	846,250	1,130,900
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)	939,647,698	1,006,416,358
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 14,916,446
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	1,121,850,037	1,214,661,401
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	2,062,343,985	2,222,208,659
19	Revenue less expenses. Subtract line 18 from line 12.......	150,718,176	174,764,218
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	4,238,185,377	4,247,026,101
21	Total liabilities (Part X, line 26).............	1,458,003,700	1,413,766,101
22	Net assets or fund balances. Subtract line 21 from line 20.....	2,780,181,677	2,833,260,000

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 544,351,000 including grants of $ 0 ) (Revenue $ 526,913,000 )
	SEE SCHEDULE O

4b	(Code: ) (Expenses $ 405,175,000 including grants of $ 0 ) (Revenue $ 539,843,000 )
	SEE SCHEDULE O

4c	(Code: ) (Expenses $ 267,757,000 including grants of $ 0 ) (Revenue $ 227,921,000 )
	SEE SCHEDULE O

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 825,810,290 including grants of $ 1,130,900 ) (Revenue $ 897,354,471 )
4e	Total program service expenses2,043,093,290

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	12,041,935	11,429,832	2,780,172

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	9,058
e	Government grants (contributions)		1e	29,468,596

f	All other contributions, gifts, grants, and similar amounts not included above		1f	145,252,202

g	Noncash contributions included in lines 1a - 1f:$		1g	287,113

h Total. Add lines 1a-1f.......		174,729,856

		Business Code
2a	PATIENT SERVICE	900099	1,774,615,656	1,774,615,656
b	MEDICARE/MEDICAID	900099	277,876,812	277,876,812
c	PROVIDER FEE	900099	93,729,725	93,729,725
d	OUTREACH PROGRAMS	900099	23,912,612	23,912,612
e	REVENUE FROM HEALTH RELATED ACTIVITIES	900099	8,643,438	8,643,438
f	All other program service revenue.		13,253,228	13,253,228
g	Total. Add lines 2a–2f .....		2,192,031,471

3 Investment income (including dividends, interest, and othersimilar amounts) ......			27,670,652			27,670,652
4 Income from investment of tax-exempt bond proceeds			314			314
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents		1,888,642	6a
b	Less: rental expenses		677,815	6b
c	Rental income or (loss)	0	1,210,827	6c
d	Net rental income or (loss).......			1,210,827			1,210,827
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	62,265		7a
b	Less: cost or other basis and sales expenses	82,671		7b
c	Gain or (loss)	-20,406		7c
d	Net gain or (loss).........			-20,406			-20,406
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	3,927,981			3,927,981
b	INVESTMENT INCOME FROM RELATED PROGRAM		900099	-15,686,461			-15,686,461
c	PARKING INCOME		900099	397,697			397,697
d	All other revenue ....			12,710,946			12,710,946
e	Total. Add lines 11a–11d ......			1,350,163
12	Total revenue. See instructions.....			2,396,972,877	2,192,031,471		30,211,550

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	1,130,900	1,130,900
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 ...........	8,442,358	3,443,315	4,636,653	362,390
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	757,218	454,331	302,887
7	Other salaries and wages........	648,758,373	586,228,957	62,529,416
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	66,562,673	62,311,694	4,250,979
9	Other employee benefits .......	231,421,042	224,703,024	6,718,018
10	Payroll taxes ...........	50,474,694	47,210,270	3,264,424
11	Fees for services (non-employees):
a	Management ......	8,730,171	4,603,915	4,126,256
b	Legal .........	4,414,259		4,414,259
c	Accounting ...........	659,848	7,917	651,931
d	Lobbying ...........	37,000	37,000
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)	675,731,778	646,292,572	29,439,206
12	Advertising and promotion ....	8,163,509	362,908	7,800,601
13	Office expenses .......	232,888,753	229,569,743	3,319,010
14	Information technology ......	25,323,338	25,291,998	31,340
15	Royalties ..	0
16	Occupancy ...........	31,608,525	18,615,671	12,992,854
17	Travel ............	884,471	670,386	214,085
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	0
20	Interest ...........	31,041,895	31,041,895
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	91,326,888	89,492,293	1,834,595
23	Insurance ...	14,803,042	3,282,667	11,520,375
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	PROVIDER FEES	24,127,049	24,127,049
b	UNCOLLECTIBLES	18,372,358	18,372,358
c	UTILITIES	11,833,577	10,994,812	838,765
d	LICENSES & TAXES	3,474,130	1,991,856	1,482,274
e	All other expenses	31,240,810	12,855,759	3,830,995	14,554,056
25	Total functional expenses. Add lines 1 through 24e	2,222,208,659	2,043,093,290	164,198,923	14,916,446
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 .........			370,377,463	2	426,694,230
3	Pledges and grants receivable, net ......			86,913,785	3	182,932,638
4	Accounts receivable, net .............			603,195,802	4	587,841,831
5	Loans and other receivables from 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 .......
				3,958,415	5	4,567,500
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 ............			16,536,441	8	17,634,196
9	Prepaid expenses and deferred charges ......			45,528,109	9	40,505,186
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	2,608,223,543
b	Less: accumulated depreciation	10b	866,327,243	1,772,294,720	10c	1,741,896,300
11	Investments—publicly traded securities .			78,469,561	11	77,486,036
12	Investments—other securities. See Part IV, line 11 .....			1,092,535,479	12	1,041,464,792
13	Investments—program-related. See Part IV, line 11 ..			-87,569,346	13	-97,978,456
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			255,944,948	15	223,981,848
16	Total assets. Add lines 1 through 15 (must equal line 33)...			4,238,185,377	16	4,247,026,101

17	Accounts payable and accrued expenses .....	322,370,500	17	340,588,535
18	Grants payable ...	0	18	0
19	Deferred revenue .........	0	19	0
20	Tax-exempt bond liabilities .........	839,961,227	20	821,831,050
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	295,671,973	25	251,346,516
26	Total liabilities. Add lines 17 through 25..	1,458,003,700	26	1,413,766,101

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	2,103,403,597	27	2,070,261,639
28	Net assets with donor restrictions ...........	676,778,080	28	762,998,361
	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 ...........	2,780,181,677	32	2,833,260,000
33	Total liabilities and net assets/fund balances ........	4,238,185,377	33	4,247,026,101

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