2024-06-17T10:08:48-05:00 2023-06-30 135565207 KPMG LLP MISSION TOWERS I 3975 FREEDOM CIRCLE DR SANTA CLARA CA 95054 990 2022-07-01 330278018 RADY CHILDREN'S HEALTH SERVICES -SAN DIEGO RADY 8585761700 3020 CHILDRENS WAY MC 5001 SAN DIEGO CA 921234282 JAMES J ULI JR CFO/TREASURER 8585761700 2024-06-14 1 JAMES ULI JR 999009999 0 HOLLY K MOEN P01800653 4083675764 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z PATRICK FRIAS MD 3020 CHILDRENS WAY MC SAN DIEGO CA CA 92123 63446100 0 X WWW.RCHSD.ORG X 1988 CA RADY CHILDREN'S HEALTH SERVICES-SAN DIEGO WAS FORMED TO AID AND ASSIST RADY CHILDREN'S HOSPITAL-SAN DIEGO IN CARRYING OUT THE HOSPITAL'S EXEMPT PURPOSE. 5 5 61 0 0 0 0 0 59816198 63446100 0 0 0 0 59816198 63446100 0 0 0 0 5002288 5297901 0 0 0 51253836 51642113 56256124 56940014 3560074 6506086 28013493 14619437 21167266 1267124 6846227 13352313 RADY CHILDREN'S HEALTH SERVICES - SAN DIEGO WAS FORMED TO AID AND ASSIST RADY CHILDREN'S HOSPITAL - SAN DIEGO IN CARRYING OUT THE HOSPITAL'S EXEMPT PURPOSE. 0 0 54898705 63446100 RADY CHILDREN'S HEALTH SERVICES - SAN DIEGO IS A NON-PROFIT PUBLIC BENEFIT CORPORATION. THE SPECIFIC PURPOSE OF THE CORPORATION IS TO AID AND ASSIST RADY CHILDREN'S HOSPITAL - SAN DIEGO IN CARRYING OUT THE HOSPITAL'S EXEMPT PURPOSE AND PROGRAMS. 54898705 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 7 0 1 61 1 0 0 0 0 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X NISHANTHA RATNAYAKE 8885761700 3020 CHILDRENS WAY MC 5001 SAN DIEGO CA 921234282 DAN LESSER MD BOARD MEMBER 2.00 4.00 X 0 0 0 JOHN M GILCHRIST JR BOARD MEMBER 2.00 4.00 X 0 0 0 PAUL HERING CHAIR 4.00 10.00 X X 0 0 0 S DOUGLAS HUTCHESON VICE CHAIR 4.00 10.00 X X 0 0 0 SCOTT N WOLFE BOARD MEMBER 2.00 4.00 X 0 0 0 ANGELA M VIEIRA SECRETARY 1.00 39.00 X 0 623549 60204 BELINDA SANTOS-RAMIREZ ASSISTANT SECRETARY 1.00 39.00 X 0 136267 17279 GAIL KNIGHT MD SR VP, CMO 1.00 39.00 X 0 870429 12976 JAMES J ULI JR SVP, CFO, TREASURER 1.00 39.00 X 0 837703 21610 JILL STRICKLAND SR VP, CAO 1.00 39.00 X 0 716172 29336 NICHOLAS M HOLMES MD SR VP, COO 1.00 39.00 X 0 926360 38429 PATRICK FRIAS MD PRESIDENT & CEO 1.00 39.00 X 0 1741714 38924 STEPHEN JENNINGS SR VP, EXEC DIR FOUNDATION 0.00 40.00 X 0 717267 56937 ANH DINH SHARMA THRU 623 PHARMACIST IN CHIEF 40.00 0.00 X 228389 0 7074 KATHERINE IRENE TWEEDY-LI PHARMACIST, HOMECARE 40.00 0.00 X 172397 0 6757 LINDA SCHWARTZ PHARMACIST, RETAIL 40.00 0.00 X 172068 0 12826 MARY LEE PHARMACIST, HOMECARE 40.00 0.00 X 191673 0 22148 MICHAEL CLARK MGR, HOME CARE PHARMACY 40.00 0.00 X 227905 0 21857 MONICA EVANS PHARMACIST, RETAIL 40.00 0.00 X 207103 0 16516 DONALD B KEARNS MD MMM PRESIDENT EMERITUS 0.00 20.00 X 0 171360 -30716 MARGARETA E NORTON FORMER OFFICER 0.00 10.00 X 0 135131 0 1199535 6875952 332157 10 1 1 0 CIBD DISTRIBUTORS 2670 N MAIN ST STE 100 SANTA ANA CA 92705 MEDICAL SUPPLIER 5224727 MCKESSON MEDICAL-SURGICAL MINNESOTA PO BOX 732583 DALLAS TX 753732583 MEDICAL SUPPLIER 3074195 THERACOM LLC 1195 TRADEMARK DR SUITE 102-C RENO NV 89521 MEDICAL SUPPLIER 1760580 MEDLINE INDUSTRIES LP 1 MEDLINE WILMER TX 75172 MEDICAL SUPPLIER 610899 CARDINAL HEALTH 108 LLC 6640 ECHO DR SUITE J RENO NV 895062635 MEDICAL SUPPLIER 578608 9 NET PATIENT REVENUE 622110 47368095 47368095 OUTPATIENT PHARMACEUTI 456110 16078005 16078005 63446100 63446100 63446100 0 0 280325 195119 85206 4077037 2837804 1239233 940539 654658 285881 370770 281563 89207 21490 21490 31444 31444 200804 160643 40161 42861 42861 2818901 2818901 97821 63584 34237 PHARMACEUTICAL SUPPLIES 43029485 42888353 141132 MEDICAL SUPPLIES 2870532 2832432 38100 NUTRITIONAL SUPPLIES 1981286 1981286 EQUIPMENT RENTAL 130654 130146 508 46065 11355 34710 56940014 54898705 2041309 0 18918364 1354467 7050726 7785233 1835564 2413506 899737 740244 208839 159493 0 2906738 28013493 14619437 1114781 1267124 20052485 0 21167266 1267124 X 6846227 13352313 6846227 13352313 28013493 14619437 6506086 0 X 0 1 X 1 0 X X 1 RADY CHILDREN'S HOSPITAL SAN DIEGO 951691313 3 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 SCHEDULE A, PART I (H) THE ORGANIZATION WAS FORMED TO AID AND ASSIST RADY CHILDREN'S HOSPITAL - SAN DIEGO, A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION ("RCHSD") , IN CARRYING OUT RCHSD'S CHARITABLE PURPOSE AND PROGRAMS. 150096490 2941477 2637022 5964478 206709 149503802 144331521 15072302 -2487608 6699197 120528 150096490 114591220 4258030 29121590 3568781 70538 144331521 112673421 5561460 701427 4235454 109634 114591220 109949631 4481919 2755878 4421460 92547 112673421 0.48158 0.43000 0.08842 1 1 1 318739 317711 1028 580998 422533 158465 159493 RECEIVABLE FROM AFFILIATE 2906738 2906738 X PART V, LINE 4: RADY CHILDREN'S BOARD DESIGNATED ENDOWMENT FUNDS SUPPORT THE HIGHEST AND MOST URGENT NEEDS OF THE ORGANIZATION AS DETERMINED BY ITS BOARD OF TRUSTEES. IN ADDITION, DONOR DESIGNATED (OR RESTRICTED) ENDOWMENT FUNDS SUPPORT A WIDE RANGE OF INITIATIVES IDENTIFIED BY DONORS. PART X, LINE 2: U.S. GAAP REQUIRES MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY RCHHC AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN TAX POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. RCHHC HAS NOT TAKEN ANY SIGNIFICANT UNCERTAIN TAX POSITIONS THEREFORE NO LIABILITY (OR ASSET) HAS BEEN RECOGNIZED AS OF JUNE 30, 2023. X 0 0 1 1 0 0 0 0 0 0 0 PATRICK FRIAS MD PRESIDENT & CEO 0 1160253 0 355496 0 225965 0 9150 0 29774 0 1780638 0 0 NICHOLAS M HOLMES MD SR VP, COO 0 658247 0 144134 0 123979 0 9150 0 29279 0 964789 0 0 GAIL KNIGHT MD SR VP, CMO 0 607147 0 142494 0 120788 0 9150 0 3826 0 883405 0 0 JAMES J ULI JR SVP, CFO, TREASURER 0 650826 0 137968 0 48909 0 9150 0 12460 0 859313 0 0 STEPHEN JENNINGS SR VP, EXEC DIR FOUNDATION 0 498773 0 118970 0 99524 0 28244 0 28693 0 774204 0 0 JILL STRICKLAND SR VP, CAO 0 535578 0 146326 0 34268 0 9150 0 20186 0 745508 0 0 ANGELA M VIEIRA SECRETARY 0 491406 0 69006 0 63137 0 45294 0 14910 0 683753 0 0 MICHAEL CLARK MGR, HOME CARE PHARMACY 218905 0 9000 0 0 0 2878 0 18979 0 249762 0 0 0 ANH DINH SHARMA THRU 623 PHARMACIST IN CHIEF 216351 0 9531 0 2507 0 6761 0 313 0 235463 0 0 0 MONICA EVANS PHARMACIST, RETAIL 199797 0 0 0 7306 0 3267 0 13249 0 223619 0 0 0 MARY LEE PHARMACIST, HOMECARE 191673 0 0 0 0 0 5750 0 16398 0 213821 0 0 0 LINDA SCHWARTZ PHARMACIST, RETAIL 172068 0 0 0 0 0 5162 0 7664 0 184894 0 0 0 KATHERINE IRENE TWEEDY-LI PHARMACIST, HOMECARE 172397 0 0 0 0 0 5172 0 1585 0 179154 0 0 0 BELINDA SANTOS-RAMIREZ ASSISTANT SECRETARY 0 125103 0 6340 0 4824 0 -1564 0 18843 0 153546 0 0 DONALD B KEARNS MD MMM PRESIDENT EMERITUS 0 171360 0 0 0 0 0 -30716 0 0 0 140644 0 0 MARGARETA E NORTON FORMER OFFICER 0 135131 0 0 0 0 0 0 0 0 0 135131 0 0 PART I, LINE 1A RADY CHILDREN'S HEALTH SERVICES - SAN DIEGO (RCHSS) PROVIDED A DISCRETIONARY SPENDING ACCOUNT TO FIVE OFFICERS LISTED ON FORM 990, PART VII. THE AMOUNT PROVIDED WAS INCLUDED IN EACH OF THE INDIVIDUAL'S TAXABLE INCOME. PART I, LINE 3 RADY CHILDREN'S HEALTH SERVICES - SAN DIEGO (RCHSS) RELIED ON A RELATED ORGANIZATION, RADY CHILDREN'S HOSPITAL AND HEALTH CENTER (RCHHC), THAT USES ONE OR MORE OF THE METHODS DESCRIBED IN SCHEDULE J. PART I, LINE 3, TO ESTABLISH THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL'S COMPENSATION. SEE FORM 990, PART VI, SECTION B, LINE 15 FOR ADDITIONAL INFORMATION. PART I, LINES 4A-B RADY CHILDREN'S HOSPITAL AND HEALTH CENTER HAS ESTABLISHED A NON-QUALIFIED PLAN PURSUANT TO 457(F) OF THE INTERNAL REVENUE CODE. THE PURPOSE OF THIS PLAN IS TO INCENTIVIZE RADY CHILDREN'S HOSPITAL - SAN DIEGO ELIGIBLE SENIOR MANAGEMENT EMPLOYEES (PRESIDENT, SENIOR VICE PRESIDENTS, VICE PRESIDENTS, SENIOR MANAGING DIRECTORS) IN RECOGNITION OF THE FACT THAT THEY ARE REQUIRED TO DEVOTE SIGNIFICANT AMOUNTS OF TIME, SKILL AND ENERGY TO THE ORGANIZATION. THE AMOUNTS INCLUDED IN SCHEDULE J PART II COLUMN (C) ARE SUBJECT TO SUBSTANTIAL FUTURE SERVICE REQUIREMENTS TO THE ORGANIZATION AND ARE SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE. ONCE VESTED THE AMOUNTS UNDER THIS PLAN ARE REPORTED ON FORM W-2 AS TAXABLE COMPENSATION TO THE INDIVIDUAL. THE FOLLOWING INDIVIDUALS RECEIVED PAYMENTS FROM THE PLAN DURING CALENDAR YEAR 2022: ANH SHARMA ($2,507), GAIL KNIGHT, MD ($105,788), STEPHEN JENNINGS ($84,524), ANGELA M. VIEIRA ($51,137), PATRICK FRIAS, MD ($172,355), NICHOLAS M. HOLMES, MD ($108,979), JAMES J. ULI, JR ($33,909), AND JILL STRICKLAND ($19,268). PART I, LINE 4A ANH SHARMA RECIEVED $42,564 IN SEVERANCE PAYMENTS. FORM 990, PART VI, SECTION A, LINE 6 RADY CHILDREN'S HEALTH SERVICES - SAN DIEGO (RCHSS) IS THE SOLE MEMBER AS THAT TERM IS DEFINED IN CALIFORNIA CORPORATIONS CODE 5056 (MEMBER) OF RADY CHILDREN'S HOSPITAL SAN DIEGO (RCH-SD). FORM 990, PART VI, SECTION A, LINE 7A THE RCHSS BOARD OF DIRECTORS CONSISTS OF THOSE INDIVIDUALS SERVING AS THE BOARD OF TRUSTEES OF THE MEMBER. ONLY THE MEMBER MAY REMOVE A DIRECTOR. THE FOLLOWING ACTIONS OF THE RCHSS BOARD REQUIRE "PRIOR WRITTEN APPROVAL" OF THE MEMBER TO BE EFFECTIVE: - ANY AMENDMENT, REVISION, MODIFICATION OF THE ARTICLES OF INCORPORATION OR THE BYLAWS - ANY CHANGE IN THE NATURE OF THE BUSINESS ACTIVITIES OF RCHSS - APPROVAL OF OPERATING AND CAPITAL BUDGETS OF RCHSS - BORROWING ANY AMOUNT OR INCURRING ANY DEBT IN THE AMOUNT OF $100,000 OR MORE - MAKING OR INCURRING ANY UNBUDGETED EXTRAORDINARY OR NON-RECURRING EXPENSE OR EXPENDITURE OF $100,000. THE RCHSS BOARD CANNOT AUTHORIZE OR DIRECT ANY OFFICER OF RCHSS TO PERFORM OR COMMIT ANY OF THE FOLLOWING ACTS, WITHOUT PRIOR WRITTEN APPROVAL OF THE MEMBER: - BORROW MONEY IN RCHSS'S NAME OR UTILIZE PROPERTY OWNED BY RCHSS AS SECURITY FOR LOANS, EXCEPT IN THE ORDINARY COURSE OF BUSINESS - MAKE, EXECUTE, OR DELIVER ANY ASSIGNMENT FOR THE BENEFIT OR CREDITORS, OR ANY BOND, CONFESSION, JUDGMENT, CHATTEL MORTGAGE, SECURITY AGREEMENT, DEED, GUARANTY, INDEMNITY BOND, SURETY BOND, CONTRACT TO SELL OR BILL OF SALE OF THE PROPERTY OF RCHSS, EXCEPT IN THE ORDINARY COURSE OF BUSINESS. - ACQUIRE, PURCHASE, DEVELOP, IMPROVE, SELL, LEASE OR MORTGAGE ANY CORPORATE REAL ESTATE OR ANY INTEREST THEREIN OR ENTER INTO ANY CONTRACT FOR ANY SUCH PURPOSES. - MAKE ANY LOAN OR INVESTMENT OF ANY RCHRC ASSETS, OR ENTER INTO ANY CONTRACT OR INCUR ANY LIABILITY ON BEHALF OF RCHRC OTHER THAN FOR FAIR CONSIDERATION OR IN THE ORDINARY COURSE OF BUSINESS RELATING TO ITS NORMAL DAILY OPERATION. FORM 990, PART VI, SECTION A, LINE 7B PLEASE REFER TO LINE 7A EXPLANATION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS REVIEWED BY THE CFO AND THEN PROVIDED TO THE ORGANIZATION'S AUDIT AND CORPORATE RESPONSIBILITY COMMITTEE FOR REVIEW. FOLLOWING REVIEW BY THE COMMITTEE, THE RETURNS WERE FINALIZED, SIGNED AND SUBMITTED TO THE INTERNAL REVENUE SERVICE. A COMPLETE COPY OF THE FORM 990 WAS PROVIDED TO EACH VOTING BOARD MEMBER PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C ON AN ANNUAL BASIS AND UPON ELECTION OR APPOINTMENT, THE POLICY AND DISCLOSURE STATEMENT IS DISTRIBUTED TO ALL BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES AND MEDICAL STAFF LEADERS. ALL COMPLETED AND SIGNED STATEMENTS ARE RETURNED TO THE CORPORATE COMPLIANCE OFFICER FOR REVIEW. IF A PERSON DISCLOSES A POTENTIAL OR ACTUAL CONFLICT, THE PERSON WITH THE CONFLICT OF INTEREST IS EXCLUDED FROM ANY DISCUSSION OR APPROVAL OF ANY SUCH RELATED TRANSACTION. FINANCIAL INTEREST DISCLOSURES BY BOARD MEMBERS AND OFFICERS ARE BROUGHT TO THE RCHHS BOARD OF TRUSTEES OR THE AUDIT AND CORPORATE RESPONSIBILITY COMMITTEE FOR REVIEW AND, AS NEEDED, APPROPRIATE ACTION. FINANCIAL INTEREST DISCLOSURES BY KEY EMPLOYEES AND MEDICAL STAFF LEADERS ARE REVIEWED BY THE CORPORATE COMPLIANCE OFFICER AND REFERRED TO THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OR TO THE RCHHS BOARD OF TRUSTEES. THE CORPORATE COMPLIANCE OFFICER REPORTS ANNUALLY TO THE EXECUTIVE CORPORATE COMPLIANCE COMMITTEE AND THE AUDIT AND CORPORATE RESPONSIBILITY COMMITTEE A SUMMARY OF ALL DISCLOSURES AND ACTION TAKEN, IF ANY. ALL OTHER EMPLOYEES ARE REQUIRED TO COMPLETE A DISCLOSURE STATEMENT ON AN ANNUAL BASIS THAT IS REVIEWED BY THE CORPORATE COMPLIANCE OFFICER. FORM 990, PART VI, SECTION B, LINE 15 RADY CHILDREN'S HOSPITAL AND HEALTH CENTER/RADY CHILDREN'S HOSPITAL - SAN DIEGO WORKING THROUGH THE BOARD COMPENSATION COMMITTEE HAS A PROCESS FOR ESTABLISHING, REVIEWING AND APPROVING COMPENSATION OF OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION ON A NO LESS THAN AN ANNUAL BASIS. THE COMPENSATION COMMITTEE IS COMPRISED OF INDEPENDENT, LAY MEMBERS OF THE BOARD OF TRUSTEES. PRIOR TO CONDUCTING ITS REVIEW, THE CHAIR OF THE COMPENSATION COMMITTEE DETERMINES WHETHER ANY MEMBER HAS A CONFLICT OF INTEREST WITH RESPECT TO THE MATTER(S) UNDER REVIEW. IF THERE IS A CONFLICT, THE CONFLICTED MEMBER RECUSES HIMSELF/HERSELF AND IS NOT PRESENT DURING DISCUSSION OR VOTE ON THE ARRANGEMENT UNDER REVIEW. IN DETERMINING AND APPROVING THE COMPENSATION ARRANGEMENT, THE COMMITTEE CONSIDERS ALL COMPONENTS OF COMPENSATION. IT CONSIDERS COMPARABILITY DATA AND RETAINS AN INDEPENDENT COMPENSATION CONSULTANT TO PROVIDE COMPARABILITY DATA TO THE COMMITTEE. TOTAL COMPENSATION IS TARGETED TO BE BETWEEN THE 50TH AND 75TH PERCENTILES OF THE COMPARABILITY DATA. THE COMMITTEE'S DELIBERATIONS AND DECISIONS ARE DOCUMENTED IN MINUTES THAT ARE REVIEWED AT ITS NEXT MEETING. THE COMMITTEE'S WRITTEN RECORDS INCLUDE THE (1) TERMS OF THE ARRANGEMENT WITH THE DISQUALIFIED PERSON (INCLUDING THE DATE THE ARRANGEMENT WAS APPROVED); (2) A LIST OF MEMBERS PRESENT DURING THE DISCUSSION OF THE TRANSACTION (AND HOW THE MEMBERS VOTED WHEN IT WAS APPROVED); AND (3) A DESCRIPTION OF THE COMPARABLE DATA RELIED ON BY THE COMMITTEE AND HOW IT WAS OBTAINED. FORM 990, PART VI, SECTION C, LINE 19 THE FEDERAL TAX LAWS DO NOT MANDATE THAT THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY BE MADE AVAILABLE FOR PUBLIC INSPECTION. THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. RADY CHILDREN'S HOSPITAL - SAN DIEGO 3020 CHILDRENS WAY MC 5001 SAN DIEGO CA 92123 951691313 HOSPITAL CA 501(C)(3) LINE 3 RCHHC 0 RADY CHILDREN'S HOSPITAL AND HEALTH CENTER 3020 CHILDRENS WAY MC 5001 SAN DIEGO CA 92123 953545901 SUPPORT AFFILIATES CA 501(C)(3) LINE 12B, II N/A 0 RADY CHILDREN'S HOSPITAL RESEARCH CENTER 3020 CHILDRENS WAY MC 5001 SAN DIEGO CA 92123 953814185 RESEARCH CA 501(C)(3) LINE 12B, II RCHHC 0 RADY CHILDREN'S HOSPITAL FOUNDATION-SD 3020 CHILDRENS WAY MC 5001 SAN DIEGO CA 92123 330170626 FUNDRAISING CA 501(C)(3) LINE 7 RCHHC 0 CHILDREN'S HOSPITAL INSURANCE LTD CANONS COURT 22 VICTORIA STREET HAMILTON BD BD HM12 CAPTIVE INSURANCE BD RCHHC C 0 RADY CHILDREN'S PHYSICIAN MANAGEMENT SERVICE 3860 CALLE FORTUNADA SUITE 200 SAN DIEGO CA 921234282 330670694 MGMT-PHYS OFF CA RCHHC C 0 CHILDREN'S HOSPITAL INTEGRATED RISK PROTECTION CANONS COURT 22 VICTORIA STREET HAMILTON BD BD HM12 CAPTIVE INSURANCE BD RCHHC C 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 RADY CHILDREN'S HOSPITAL - SAN DIEGO Q 229859 RADY CHILDREN'S HOSPITAL - SAN DIEGO P 2818901