Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2010
Open to Public Inspection
A For the calendar year, or tax year beginning 07-01-2010 and ending 06-30-2011
BCheck if applicable:
CName of organization
ST JOSEPH HEALTH SYSTEM FOUNDATION
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
500 S MAIN STREET
 
Room/suite
City or town, state or country, and ZIP + 4
ORANGE, CA928684507
D Employer identification number

33-0143024
E Telephone number

G Gross receipts $ 27,578,500
F Name and address of principal officer:
SISTER JAYNE HELMLINGER
 
 
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.STJHS.ORG/SJHSPROGRAMS/FOUNDATION
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet0928
K Form of organization:
 
L Year of formation: 1985
M State of legal domicile: CA
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: WE PROVIDE FUNDING AND ASSISTANCE FOR IMPROVING THE HEALTH AND WELL- BEING OF THE POOR, AND UTILIZE THE STRENGTH AND DIVERSITY OF OUR NEIGHBORS TO BUILD VIBRANT COMMUNITIES.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 9
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 6
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 0
6 Total number of volunteers (estimate if necessary) .... 6 6
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 0
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 26,263,110 22,436,200
9 Program service revenue (Part VIII, line 2g) ......... 0 0
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 3,519,987 5,040,462
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 0 0
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 29,783,097 27,476,662
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 15,758,291 16,347,210
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) 0 0
16a Professional fundraising fees (Part IX, column (A), line 11e).... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 291,860 507,199
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 16,050,151 16,854,409
19 Revenue less expenses. Subtract line 18 from line 12...... 13,732,946 10,622,253
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 75,582,000 91,500,280
21 Total liabilities (Part X, line 26)............ 55,583 286,378
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 75,526,417 91,213,902
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid Preparer's Use Only Preparer's
signatureBig Right Arrow 		Date
right pointing bullet image Preparer’s taxpayer identification number
(see instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4Big Right Arrow




 		EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? (see instructions) .........
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2010)
Form 990 (2010)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III . . . . . . . . . .
1
Briefly describe the organization’s mission: SEE SCHEDULE O
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the exempt purpose achievements for each of the organization’s three largest program services by expenses.
Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 16,460,904 including grants of $ 16,347,210 ) (Revenue $ 0 )
SEE SCHEDULE O
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services. (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 16,460,904
Form 990 (2010)
Form 990 (2010)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part I..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part II.........................
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete
Schedule D, Part IClick to see attachment.......................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in term, permanent,or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
 
No
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
 
No
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, and program service activities outside the United States? If “Yes,” complete Schedule F, Part I......... Click to see attachment
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II.. Click to see attachment
15
Yes
 
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III.. Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
Form 990 (2010)
Form 990 (2010)
Page 4
Part IV
Checklist of Required Schedules (continued)
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H.....
20a
 
No
b
Did the organization attach its audited financial statement to this return? Note: All Form 990 filers that operate one or more hospitals must attach audited financial statements. .....
20b
 
 
21
Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III..... Click to see attachment
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I......
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II...........................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If “Yes,” complete Schedule L, Part III...............
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV .........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV...................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV..
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35
Is any related organization a controlled entity within the meaning of section 512(b)(13)? .....
35
Yes
 
a
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V . . . . . . . . . .
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
0
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
 
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
0
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
 
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2010)
Form 990 (2010)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI . . . . . . . . . .
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year ..............
1a
9
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
6
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? ..
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Does the organization have members or stockholders? ................
6
Yes
 
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
Yes
 
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Does the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? ....
10b
 
 
11a
Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Does the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
Yes
 
c
Does the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this is done ....................
12c
Yes
 
13
Does the organization have a written whistleblower policy? ...............
13
 
No
14
Does the organization have a written document retention and destruction policy? .........
14
 
No
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
 
No
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line a or b, describe the process in Schedule O. (See instructions.)
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If “Yes,” has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
CA
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you make these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest policy, and financial statements available to the public.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
DARRIN MONTALVO
500 S MAIN ST 700
ORANGE,CA92868
(714) 347-7500
Form 990 (2010)
Form 990 (2010)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII . . . . . . . . . .
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) SR JAYNE HELMLINGER
CHAIRPERSON/CEO
 5.0 X   X       0 0 0
(2) TOM MAHOWALD
CFO
 2.0 X   X       0 430,168 42,030
(3) SISTER MARIAN SCHUBERT
SECRETARY
 2.0 X   X       0 0 0
(4) DOTTIE ANDREWS
BOARD MEMBER
 2.0 X           0 0 0
(5) JAIME MUNOZ
BOARD MEMBER
 2.0 X           0 0 0
(6) DEBORAH PROCTOR
BOARD MEMBER
 2.0 X           0 1,727,345 310,878
(7) JO SANDERSFELD
BOARD MEMBER
 2.0 X           0 378,891 24,981
(8) LEAH ERSOYLU
BOARD MEMBER
 2.0 X           0 0 0
(9) SORA PARK TANJASIRI DRPH
BOARD MEMBER
 2.0 X           0 0 0
(10) ALICIA LARA
BOARD MEMBER (THRU 02/2011)
 2.0 X           0 0 0
(11) JASON BARKER
FORMER CFO
 0.0           X 0 564,732 24,006












Form 990 (2010)
Form 990 (2010)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;


























1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 0 3,101,136 401,895
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet0
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet0
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 22,436,200
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		 
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet 22,436,200
Program Service Revenue Business Code
2a
b
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 0
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 5,106,600     5,106,600
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties............MediumBullet 0      
(i) Real (ii) Personal
6a Gross Rents    
b Less: rental expenses    
c Rental income or (loss)    
d Net rental income or (loss).......MediumBullet        
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory   35,700
b Less: cost or other basis and sales expenses   101,838
c Gain or (loss)   -66,138
d Net gain or (loss)..........MediumBullet -66,138     -66,138
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet 0      
Miscellaneous Revenue Business Code
11a            
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ......MediumBullet 0
12 Total revenue. See Instructions....MediumBullet 27,476,662     5,040,462
Form 990 (2010)
Form 990 (2010)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21 16,117,210 16,117,210
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22 0  
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16 230,000 230,000
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 0      
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 0      
7 Other salaries and wages 0      
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) .... 0      
9 Other employee benefits ....... 0      
10 Payroll taxes ........... 0      
11 Fees for services (non-employees):        
a Management ...... 348,504   348,504  
b Legal ......... 7,166 7,166    
c Accounting ........... 0      
d Lobbying ........... 0      
e Professional fundraising. See Part IV, line 17.. 0  
f Investment management fees ...... 0      
g Other .......... 144,545 106,528 38,017  
12 Advertising and promotion .... 0      
13 Office expenses ....... 0      
14 Information technology ...... 6,984   6,984  
15 Royalties .. 0      
16 Occupancy ........... 0      
17 Travel ............ 0      
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 0      
20 Interest ........... 0      
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 0      
23 Insurance .............. 0      
24 Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a
b
c
d
e
f All other expenses        
25 Total functional expenses. Add lines 1 through 24f 16,854,409 16,460,904 393,505 0
26 Joint costs. Check here MediumBullet if following
SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation 		       
Form 990 (2010)
Form 990 (2010)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing ..........   1  
2 Savings and temporary cash investments ....... 1,649,136 2 3,858,794
3 Pledges and grants receivable, net .........   3  
4 Accounts receivable, net .........   4  
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net ............. 178,847 7 0
8 Inventories for sale or use ..............   8  
9 Prepaid expenses and deferred charges ............   9  
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 39,972
b Less: accumulated depreciation. ..... 10b 0 94,105 10c 39,972
11 Investments—publicly traded securities .......... 70,445,621 11 82,820,248
12 Investments—other securities. See Part IV, line 11 ......   12  
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ........... 3,214,291 15 4,781,266
16 Total assets. Add lines 1 through 15 (must equal line 34)... 75,582,000 16 91,500,280
Liabilities 17 Accounts payable and accrued expenses . 0 17 8,378
18 Grants payable .......... 55,583 18 278,000
19 Deferred revenue ..........   19  
20 Tax-exempt bond liabilities ..........   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities. Complete Part X of Schedule D.....   25  
26 Total liabilities. Add lines 17 through 25..... 55,583 26 286,378
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 75,516,830 27 91,204,315
28 Temporarily restricted net assets ..... 9,587 28 9,587
29 Permanently restricted net assets .....   29  
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 75,526,417 33 91,213,902
34 Total liabilities and net assets/fund balances ..... 75,582,000 34 91,500,280
Form 990 (2010)
Form 990 (2010)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI . . . . . . . . . .
1
Total revenue (must equal Part VIII, column (A), line 12) . . .
1
27,476,662
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
16,854,409
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
10,622,253
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
75,526,417
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
5,065,232
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) . . . . . .
6
91,213,902
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII . . . . . . . . . .
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?..
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O............................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
 
No
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
 
 
Form 990 (2010)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
ST JOSEPH HEALTH SYSTEM FOUNDATION
 
Employer identification number

33-0143024
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(i)
Name of supported organization 		(ii)
EIN 		(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions)) 		(iv)
Is the organization in col. (i) listed in your governing document? 		(v)
Did you notify the organization in col. (i) of your support? 		(vi)
Is the organization in col. (i) organized in the U.S.? 		(vii)
Amount of support?
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .... 21,338,867 14,966,583 3,323,181 26,263,110 22,436,200 88,327,941
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.. 21,338,867 14,966,583 3,323,181 26,263,110 22,436,200 88,327,941
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.           88,327,941
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
7 Amounts from line 4.. 21,338,867 14,966,583 3,323,181 26,263,110 22,436,200 88,327,941
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. 7,571,023 4,033,193 0 3,519,987 5,106,600 20,230,803
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..            
11 Total support (Add lines 7 through 10).           108,558,744
12
12
0
13
Section C. Computation of Public Support Percentage
14
14
81.364 %
15
15
80.474 %
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (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) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)            
13 Total support (Add lines 9, 10c, 11 and 12.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2010
Name of organization
ST JOSEPH HEALTH SYSTEM FOUNDATION
 
Employer identification number

33-0143024
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




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—
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part I
Name of organization
ST JOSEPH HEALTH SYSTEM FOUNDATION
  		Employer identification number

33-0143024
Part I
Contributors (see Instructions)
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part II
Name of organization
ST JOSEPH HEALTH SYSTEM FOUNDATION
  		Employer identification number

33-0143024
Part II
Noncash Property (see Instructions)
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part III
Name of organization
ST JOSEPH HEALTH SYSTEM FOUNDATION
  		Employer identification number

33-0143024
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use 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		 (c)
Use 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		 (c)
Use 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		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data


Software ID:  
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SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
ST JOSEPH HEALTH SYSTEM FOUNDATION
 
Employer identification number

33-0143024
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
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? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may 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. ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06 ........ 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116, 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 XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116, 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)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
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?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV 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  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to 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 ....      
b Contributions ........      
c Investment earnings or losses ...      
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........ 		     
f Administrative expenses ....      
g End of year balance ......      
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet  
b
Permanent endowment: SchDMd Bullet  
c
Term endowment: SchDMd Bullet  
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Investments—Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of investment (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................      
b Buildings ................ 39,972   0 39,972
c Leasehold improvements ............        
d Equipment ................        
e Other .................        
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 39,972
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) INTEREST RECEIVABLE 1,208
(2) INTERCOMPANY AFFILIATES 4,780,058







Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 4,781,266
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes 0








Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 0
2. Fin 48 (ASC 740) Footnote. In Part XIV, 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 (ASC740).
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1  
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2  
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3  
4 Net unrealized gains (losses) on investments .......................... 4  
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8  
9 Total adjustments (net). Add lines 4 - 8 ............................. 9  
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10  
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
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 on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 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 XIV): ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5  
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
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 XIV): ............ 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 XIV): ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5  
Part XIV
Supplemental Information
Complete this part to 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; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
CONSOLIDATED AUDIT FOOTNOTE FOR FIN 48 (ASC 740) SCHEDULE D, PART X, LINE 2 ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES, CLARIFIES THE ACCOUNTING FOR INCOME TAXES BY PRESCRIBING A MINIMUM RECOGNITION THRESHOLD THAT A TAX POSITION IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. ASC 740 ALSO PROVIDES GUIDANCE ON DERECOGNITION, MEASUREMENT, CLASSIFICATION, INTEREST AND PENALTIES, DISCLOSURE, AND TRANSITION. THE GUIDANCE IS APPLICABLE TO PASS-THROUGH ENTITIES AND TAX-EXEMPT ORGANIZATIONS. NO SIGNIFICANT TAX LIABILITY OR TAX BENEFITS, INTEREST OR PENALTIES WAS ACCRUED AT JUNE 30, 2011 OR 2010.
Schedule D (Form 990) 2010

Additional Data


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Software Version:  




SCHEDULE F
(Form 990)

Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image 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 See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
ST JOSEPH HEALTH SYSTEM FOUNDATION
 
Employer identification number

33-0143024
Part I
General Information on Activities Outside the United States. Complete if the organization answered
“Yes” to Form 990, Part IV, line 14b.
1
For grantmakers. 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? ...................................
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of grant funds outside the
United States.
3
Activites per Region. (Use Part V if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees or agents in region or independent contractors (d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in region		 (f) Total
expenditures for region/investments
in region
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total .....      
b Total from continuation sheets to Part I ...      
c Totals (add lines 3a and 3b)      
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2010
Schedule F (Form 990) 2010
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990,
Part IV, line 15, for any recipient who received more than $5,000. Check this box if no one recipient received more than $5,000 ........ MediumBullet
Use Part V 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
of non-cash
assistance 		(h) Description
of non-cash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
Cent. America/Caribbean CHOLERA TREATMENT AND PREVENTION-HAITI 40,000 CHECK      
Cent. America/Caribbean CHOLERA TREATMENT AND PREVENTION-HAITI 60,000 CHECK      
Middle East/North Africa MEDICAL CLINICS SERVING FLOOD VICTIMS - PAKISTAN 30,000 CHECK      
East Asia/Pacific EMERGENCY RELIEF-JAPAN EARTHQUAKE 25,000 CHECK      
Cent. America/Caribbean MALNOURISHMENT TREATMENT PROGRAM-HAITI 75,000 CHECK      
             
             
             
             
             
             
             
             
             
             
             
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 .....MediumBullet
5
3
Enter total number of other organizations or entities ........................MediumBullet
0
Schedule F (Form 990) 2010
Schedule F (Form 990) 2010Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.
Use Part V if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant 		(e) Manner of cash
disbursement 		(f) Amount of
non-cash
assistance 		(g) Description
of non-cash
assistance 		(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2010
Schedule F (Form 990) 2010
Page 4
Part IV
Foreign Forms
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 (see instructions for Form 926).................
2 Did the organization have an interest in a foreign trust during the tax year? If " Yes," the organization may be required to file Form 3520 and/or Form 3520-A. (see instructions for Forms 3520 and 3520-A)..........
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)..............................
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, Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see instructions for Form 8621)
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)....................................
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see instructions for Form 5713)................................................
Schedule F (Form 990) 2010
Schedule F (Form 990) 2010
Page 5
Part V
Supplemental Information
Complete this part to provide the information (see instructions) required in Part I, line 2, and any additional information.
Identifier ReturnReference Explanation
ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS Schedule F, Part I, LINE 2 FOUNDATION STAFF TAKES REASONABLE STEPS TO INVESTIGATE A POTENTIAL GRANTEE'S CAPABILITY OF AND COMMITMENT TO EXECUTING THE PURPOSE OF THE GRANT. GRANTEES ARE REQUIRED TO PROVIDE MID YEAR AND END OF YEAR REPORTS ON THE GRANT'S FINANCIAL STATUS AND PROGRESS ON ACCOMPLISHING THE GRANT'S PURPOSES.
ACCOUNTING METHOD SCHEDULE F, PART II, LINE 1, COLUMN E THE ACCRUAL METHOD OF ACCOUNTING WAS USED TO DETERMINE THE AMOUNTS IN COLUMN E.
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
Schedule F (Form 990) 2010
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," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
ST JOSEPH HEALTH SYSTEM FOUNDATION
 
Employer identification number
33-0143024
Part I
General Information on Grants and Assistance
1
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? ....................................
2
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 Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) ALCOHOL DRUG CARE SERVICES528 FIFTH STREET
EUREKA,CA95501 		68-0218628 501(C)(3) 46,430       WELLNESS&PREVENTION
(2) AMERICAN LUNG ASSOCIATION424 PENDELTON WAY
OAKLAND,CA94621 		94-0362650 501(C)(3) 25,000       WELLNESS&PREVENTION
(3) APPLE VALLEY POLICE COMMUNITY LEAGUE14931 DALE EVANS
APPLE VALLEY,CA92307 		75-3139382 501(C)(3) 25,000       WELLNESS&PREVENTION
(4) BOYS AND GIRLS CLUB OF CAPISTRANO1 VIA POSITIVA
SJC,CA92675 		33-0529575 501(C)(3) 25,000       WELLNESS&PREVENTION
(5) BOYS AND GIRLS CLUB OF FULLERTON348 W COMMONWEALTH AVE
FULLERTON,CA92832 		95-1855645 501(C)(3) 60,000       WELLNESS&PREVENTION
(6) BOYS AND GIRLS CLUB OF LAGUANA BEACH1085 LAGUNA CNYN RD
LAGUNA BEACH,CA92651 		95-1878822 501(C)(3) 30,000       PROGRAM SERVICES
(7) CAMINO HEALTH CENTER30300 CAMINO CAPISTRANO
SJC,CA92675 		33-0574214 501(C)(3) 75,000       WELLNESS&PREVENTION
(8) CAPISTRANO UNIFIED SCHOOL DISTRICT25601 CAMINO DEL AVION
SJC,CA92675 		95-2321055 GOVERNMENT 60,000       WELLNESS&PREVENTION
(9) CHILDREN'S HEALTH INITIATIVE NAPA COUNTY2160 JEFFERSON ST
NAPA,CA94559 		25-1924934 501(C)(3) 25,000       WELLNESS&PREVENTION
(10) COMMUNITY ACTION OF NAPA VALLEY2310 LAUREL STREET STE 1
NAPA,CA94559 		94-1610851 501(C)(3) 20,000       FOOD DISTRIBUTION
(11) COMMUNITY ALLIANCE FOR FAMILY FARMERS1385 8TH STE B
ARCATA,CA95521 		94-2914745 501(C)(3) 10,000       MATCHING GRANTS
(12) COUNTY OF HUMBOLDT DEPT HLTH & HMN SVCS825 FIFTH ST
EUREKA,CA95501 		94-6000513 GOVERNMENT 56,000       WELLNESS&PREVENTION
(13) COVENANT HEALTH SYSTEMS3615 19TH ST
LUBBOCK,TX79410 		75-2765566 501(C)(3) 1,928,339       CARE FOR THE POOR
(14) CREERPO BOX 1347
SAN JUAN CAPISTRANO,CA92693 		33-0486106 501(C)(3) 50,000       WELLNESS&PREVENTION
(15) EUREKA RESCUE MISSIONPO BOX 76
EUREKA,CA95502 		94-6138983 501(C)(3) 10,000       FOOD DISTRIBUTION
(16) FAMILY ASSISTANCE MINISTRIES929 CALLE NEGOCIO
SAN CLEMENTE,CA92673 		33-0864870 501(C)(3) 10,000       FOOD DISTRIBUTION
(17) FAMILY ASSISTANCE MINISTRIES929 CALLE NEGOCIO
SAN CLEMENTE,CA92673 		33-0864870 501(C)(3) 50,000       WELLNESS&PREVENTION
(18) FAMILY SERVICE OF NAPA VALLEY709 FRANKLIN ST
NAPA,CA94559 		94-1236934 501(C)(3) 47,500       WELLNESS&PREVENTION
(19) FOOD FOR THE PEOPLE307 W 14TH ST
EUREKA,CA95501 		94-2772549 501(C)(3) 56,252       WELLNESS&PREVENTION
(20) FRIENDSHIP SHELTERPO BOX 4252
LAGUNA BEACH,CA92652 		33-0219404 501(C)(3) 50,000       WELLNESS&PREVENTION
(21) FULLERTON INTERFAITH EMERGENCY SERVICEPO BOX 6236
FULLERTON,CA92834 		33-0147739 501(C)(3) 20,000       FOOD DISTRIBUTION
(22) HEALTHY SMILES FOR KIDS OF OC10602 CHAPMAN AVE
GARDEN GROVE,CA92840 		38-3675065 501(C)(3) 60,000       WELLNESS&PREVENTION
(23) HUMBOLDT ALL FAITH PARTNERSHIPPO BOX 181
BAYSIDE,CA95524 		81-0621144 501(C)(3) 35,519       WELLNESS&PREVENTION
(24) HUMBOLDT AREA FOUNDATION373 INDIANOLA RD
BAYSIDE,CA95224 		23-7310660 501(C)(3) 64,000       WELLNESS&PREVENTION AND HOLIDAY FUNDING PARTNERSHIP
(25) KENNEDY COMMISSION17701 COWAN AVE
IRVINE,CA92614 		33-0959380 501(C)(3) 25,000       WELLNESS&PREVENTION
(26) LAGUNA BEACH COMMUNITY CLINIC362 THIRD STREET
LAGUNA BEACH,CA92651 		95-2637633 501(C)(3) 30,000       WELLNESS&PREVENTION
(27) LATINO HEALTH ACCESS1701 N MAIN ST
SANTA ANA,CA92706 		33-0562943 501(C)(3) 81,227       CBI BRIDGE FUNDING
(28) LATINO HEALTH ACCESS1701 N MAIN ST
SANTA ANA,CA92706 		33-0562943 501(C)(3) 35,000       WELLNESS&PREVENTION
(29) MARY'S KITCHEN517 W STRUCK AVE
ORANGE,CA92863 		33-0592109 501(C)(3) 20,000       FOOD DISTRIBUTION
(30) MARY'S SHELTERPO BOX 10433
SANTA ANA,CA92711 		33-0203768 501(C)(3) 50,000       WELLNESS&PREVENTION
(31) MENTAL HEALTH ASSOCIATION OF ORANGE822 TOWN AND COUNTRY RD
ORANGE,CA92868 		95-2036792 501(C)(3) 73,200       WELLNESS&PREVENTION
(32) MERCY HOUSING1999 BROADWAY STE 1000
DENVER,CA80202 		47-0646706 501(C)(3) 20,000       DISASTER RELIEF
(33) MISSION BASILICA SAN JUAN CAPISTRANO31520 CAMINO CAPISTRANO
SJC,CA92675 		95-1904079 501(C)(3) 10,000       FOOD DISTIBUTION
(34) MISSION HOSPITAL REGIONAL MEDICAL CENTER27700 MEDICAL CNTR
MISSION VIEJO,CA92691 		95-1643360 501(C)(3) 50,000       WELLNESS&PREVENTION
(35) MISSION HOSPITAL REGIONAL MEDICAL CENTER27700 MEDICAL CNTR
MISSION VIEJO,CA92691 		95-1643360 501(C)(3) 2,002,456       CARE FOR THE POOR
(36) MOBILE MEDICAL OFICEPO BOX 2020
EUREKA,CA95502 		68-0393522 501(C)(3) 75,000       WELLNESS&PREVENTION
(37) MOMS1128 W SANTA ANA BLVD
SANTA ANA,CA92703 		33-0518078 501(C)(3) 50,000       WELLNESS&PREVENTION
(38) NAPA VALLEY HOSPICE & ADULT DAY SERVICES414 S JEFFERSON ST
NAPA,CA94559 		68-0393144 501(C)(3) 35,000       WELLNESS&PREVENTION
(39) NORTH COAST CLINIC NETWORKS710 E STREET STE 145
EUREKA,CA95501 		68-0348781 501(C)(3) 43,000       WELLNESS&PREVENTION
(40) OC HUMAN RELATIONS1300 S GRAND ST
SANTA ANA,CA92705 		33-0438086 501(C)(3) 75,000       CBI THIRD YEAR-SAN CLEMENTE
(41) ON THE MOVE780 LINCOLN AVE
NAPA,CA94558 		75-3149095 501(C)(3) 50,000       WELLNESS&PREVENTION
(42) ONE OC1901 E FOURTH ST 100
SANTA ANA,CA92705 		95-2021700 501(C)(3) 18,000       SPONSORSHIP ROUNDTABLE
(43) ORANGE COUNTY CHILD ABUSE PREVENTION500 S MAIN AT
ORANGE,CA92868 		33-0013237 501(C)(3) 58,500       WELLNESS&PREVENTION
(44) ORANGE COUNTY CONGREGATION COMMUNITY310 W BROADWAY
ANAHEIM,CA92805 		95-3196836 501(C)(3) 75,000       CBI THIRD YEAR- THE COLLABORATIVE FOR A SAFE SAN JUAN
(45) PEP HOUSING951 PETALUMA BLVD SOUTH
PETALUMA,CA94952 		94-2565270 501(C)(3) 10,000       WELLNESS&PREVENTION
(46) PROJECT HOPE SCHOOL FOUNDATION343 E GROVE AVE
ORANGE,CA92865 		75-3099628 501(C)(3) 50,000       WELLNESS&PREVENTION
(47) PROVIDENCE SPEECH AND HEARING CENTER1301 PROVIDENCE AVE
ORANGE,CA92868 		95-6154473 501(C)(3) 34,333       WELLNESS&PREVENTION
(48) QUEEN OF THE VALLEY MEDICAL CENTER1000 TRANCAS ST
NAPA,CA94558 		94-1243669 501(C)(3) 150,000       PURCHASE OF MOBILE CLINIC
(49) QUEEN OF THE VALLEY MEDICAL CENTER1000 TRANCAS ST
NAPA,CA94558 		94-1243669 501(C)(3) 175,000       WELLNESS&PREVENTION
(50) QUEEN OF THE VALLEY MEDICAL CENTER1000 TRANCAS ST
NAPA,CA94558 		94-1243669 501(C)(3) 995,460       CARE FOR THE POOR
(51) REDWOOD COMMUNITY ACTION AGENCY904 G STREET
EUREKA,CA95501 		94-2646370 501(C)(3) 50,000       WELLNESS&PREVENTION
(52) REDWOOD EMPIRE FOOD BANK3320 INDUSTRIAL DRIVE
SANTA ROSA,CA95403 		68-0121855 501(C)(3) 20,000       FOOD DISTRIBUTION
(53) REDWOOD EMPIRE FOOD BANK3320 INDUSTRIAL DRIVE
SANTA ROSA,CA95403 		68-0121855 501(C)(3) 100,000       WELLNESS&PREVENTION
(54) REDWOOD MEMORIAL HOSPITAL2700 DOLBEER ST
EUREKA,CA95501 		94-1384665 501(C)(3) 250,000       CARE FOR THE POOR
(55) SANTA ROSA MEMORIAL HOSPITAL1165 MONTGOMERY DR
SANTA ROSA,CA95405 		94-1231005 501(C)(3) 83,000       WELLNESS&PREVENTION
(56) SANTA ROSA MEMORIAL HOSPITAL1165 MONTGOMERY DR
SANTA ROSA,CA95405 		94-1231005 501(C)(3) 909,438       CARE FOR THE POOR
(57) SRM ALLIANCE HOSPITAL SERVICES400 NORTH MCDOWELL BLVD
PETALUMA,CA94954 		68-0395200 501(C)(3) 151,100       CARE FOR THE POOR
(58) ST JOHN OF GOD13333 PALMDALE RD
VICTORVIILLE,CA92392 		95-3806996 501(C)(3) 20,000       FOOD DISTRIBUTION
(59) ST JOHN OF GOD13333 PALMDALE RD
VICTORVIILLE,CA92392 		95-3806996 501(C)(3) 100,000       WELLNESS&PREVENTION
(60) ST JOSEPH HOSPITAL OF ORANGE110 W STEWART DR
ORANGE,CA92868 		95-1643359 501(C)(3) 34,500       WELLNESS&PREVENTION
(61) ST JOSEPH HOSPITAL OF ORANGE110 W STEWART DR
ORANGE,CA92868 		95-1643359 501(C)(3) 2,312,790       CARE FOR THE POOR
(62) ST JOSEPH HOSPITAL OF EUREKA2700 DOLBEER ST
EUREKA,CA95501 		94-1156596 501(C)(3) 250,000       CARE FOR THE POOR
(63) ST JUDE HOSPITAL INC101 E VALENCIA MESA DR
FULLERTON,CA92835 		95-1643325 501(C)(3) 2,528,420       CARE FOR THE POOR
(64) ST JUDE HOSPITAL INC101 E VALENCIA MESA DR
FULLERTON,CA92835 		95-1643325 501(C)(3) 35,000       WELLNESS&PREVENTION
(65) ST JUDE HOSPITAL INC101 E VALENCIA MESA DR
FULLERTON,CA92835 		95-1643325 501(C)(3) 950,900       HEALTHY 4 LIFE
(66) ST MARY MEDICAL CENTER18300 HIGHWAY 18
APPLE VALLEY,CA92307 		95-1914489 501(C)(3) 113,906       WELLNESS&PREVENTION
(67) ST MARY MEDICAL CENTER18300 HIGHWAY 18
APPLE VALLEY,CA92307 		95-1914489 501(C)(3) 748,751       CARE FOR THE POOR
(68) ST VINCENT DE PAUL528 2ND ST
EUREKA,CA95502 		94-1573587 501(C)(3) 10,000       FOOD DISTRIBUTION
(69) ST VINCENT DE PAUL528 2ND ST
EUREKA,CA95502 		94-1573587 501(C)(3) 75,000       WELLNESS&PREVENTION
(70) TALLER SAN JOSE801 N BROADWAY
SANTA ANA,CA92701 		59-3816355 501(C)(3) 50,000       WELLNESS&PREVENTION
(71) THE INSTITUTE FOR HEALTHCARE ADVANCEMENT501 S IDAHO ST STE 300
LA HABRA,CA90631 		33-0483197 501(C)(3) 79,544       CBI BRIDGE FUNDING
(72) VOLUNTEER CENTER ORANGE COUNTY1901 E FOURTH ST
SANTA ANA,CA92705 		95-2021700 501(C)(3) 97,250       WELLNESS&PREVENTION
(73) YMCA OF OC AQUATIC CENTER13821 NEWPORT AVE STE 200
TUSTIN,CA92780 		95-1644055 501(C)(3) 10,000       DIRECTORS FUND FOR AQUATIC CENTER-SANTA ANA
2
Enter total number of section 501(c)(3) and government organizations ......................... Bullet Image
57
3
Enter total number of other organizations ................................ . Bullet Image
2
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2010

Schedule I (Form 990) 2010
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance













Part IV
Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.
Identifier Return Reference Explanation
ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS SCHEDULE I, PART I, LINE 2 FOUNDATION STAFF TAKES REASONABLE STEPS TO INVESTIGATE A POTENTIAL GRANTEE'S CAPABILITY OF AND COMMITMENT TO EXECUTING THE PURPOSE OF THE GRANT. GRANTEES ARE REQUIRED TO PROVIDE MID YEAR AND END OF YEAR REPORTS ON THE GRANT'S FINANCIAL STATUS AND PROGRESS ON ACCOMPLISHING THE GRANT'S PURPOSES.
Schedule I (Form 990) 2010


Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
ST JOSEPH HEALTH SYSTEM FOUNDATION
 
Employer identification number

33-0143024
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
 
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
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) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported in prior
Form 990 or
Form 990-EZ
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) TOM MAHOWALD (i)
(ii)		 0
265,826 		0
73,583 		0
90,759 		0
11,445 		0
30,585 		0
472,198 		0
0
(2) DEBORAH PROCTOR (i)
(ii)		 0
1,043,102 		0
426,987 		0
257,256 		0
296,978 		0
13,900 		0
2,038,223 		0
0
(3) JO SANDERSFELD (i)
(ii)		 0
189,038 		0
62,260 		0
127,593 		0
16,084 		0
8,897 		0
403,872 		0
50,793
(4) JASON BARKER (i)
(ii)		 0
316,797 		0
105,138 		0
142,797 		0
9,800 		0
14,206 		0
588,738 		0
0












Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
SUPPLEMENTAL COMPENSATION INFORMATION SCHEDULE J, PART I, LINE 1A ST. JOSEPH HEALTH SYSTEM ALLOWS FOR COMPANION TRAVEL FOR CERTAIN PRE-APPROVED, MINISTRY SPONSORED EVENTS. COMPANION TRAVEL IS TREATED AS TAXABLE COMPENSATION IN MOST CASES. IN THE CASE THAT COMPANION TRAVEL IS NOT TREATED AS TAXABLE COMPENSATION, THE INDIVIDUAL IS PROVIDING A SERVICE TO THE HEALTH SYSTEM AS A REPRESENTATIVE WITH KNOWLEDGE OF THE COMMUNITIES AND MINISTRIES WE SERVE. MEMBERS OF THE BOARD AND EXECUTIVE MANAGEMENT TEAM ARE SELECTED TO PARTICIPATE IN AN ANNUAL PILGRIMAGE TO LE PUY, FRANCE, WHERE THE SISTERS' FIRST CONGREGATION WAS FORMED. THE PURPOSE OF THE PILGRIMAGE IS FOR THE ORGANIZATION'S LEADERS TO DEVELOP A DEEPER UNDERSTANDING OF THE ROOTS AND HERITAGE OF THE ORGANIZATION IN ORDER TO CARRY OUT THE MISSION. COMPANION TRAVEL IS CONSIDERED TO BE AN ESSENTIAL PART OF THIS EXPERIENCE AND THE COMPANION ACTS AS A REPRESENTATIVE WITH KNOWLEDGE OF THE COMMUNITIES AND MINISTRIES WE SERVE. THE FOLLOWING TRUSTEES AND OFFICERS RECEIVED A BENEFIT FOR COMPANION TRAVEL THAT WAS INTENDED TO BE COMPENSATION. THE BENEFITS WERE PAID BY ST. JOSEPH HEALTH SYSTEM FOUNDATION'S TAX-EXEMPT PARENT, ST. JOSEPH HEALTH SYSTEM. JO SANDERSFELD - $6,574
SCHEDULE J, PART I, LINE 3   THE CHIEF EXECUTIVE OFFICER OF ST. JOSEPH HEALTH SYSTEM FOUNDATION (SJHSF) IS NOT COMPENSATED BY SJHSF OR ANY OTHER RELATED OR UNRELATED ORGANIZATION FOR HER SERVICES AS CEO OF SJHSF.
SCHEDULE J, PART I, LINE 4B   EXECUTIVES COULD PARTICIPATE IN A NON-QUALIFIED DEFERRED COMPENSATION PLAN UNDER INTERNAL REVENUE CODE 457(F). THE PLAN WAS FROZEN EFFECTIVE DECEMBER 31, 2007 AFTER WHICH TIME NO FURTHER CONTRIBUTIONS WERE PERMITTED TO THE PLAN. THIS PLAN WILL CEASE TO EXIST ONCE ALL BENEFITS HAVE BEEN DISTRIBUTED IN ACCORDANCE WITH PROVISIONS OF THE PLAN. THE FOLLOWING INDIVIDUAL RECEIVED PAYMENT FROM THE 457(F) PLAN: JO SANDERSFELD - $50,793
SCHEDULE J, PART I, LINE 7   SJHSF DID NOT PROVIDE ANY NON-FIXED PAYMENTS TO THE PERSONS LISTED IN PART VII. THEIR COMPENSATION WAS PAID BY RELATED ORGANIZATIONS FOR THEIR SERVICES AS EXECUTIVES OF THOSE ORGANIZATIONS. A PORTION OF ST. JOSEPH HEALTH SYSTEM EXECUTIVE'S SALARY IS PLACED "AT-RISK" AND IS NOT AWARDED UNLESS SPECIFIC STRATEGIC OBJECTIVE TARGETS ARE MET OR EXCEEDED. THE AT-RISK EXECUTIVE PLAN IS DESIGNED TO MOTIVATE AND REWARD EXECUTIVES FOR TEAM PERFORMANCE THAT SUPPORTS THE STRATEGIC GOALS AND SUCCESSFUL PERFORMANCE OF ST. JOSEPH HEALTH SYSTEM. AT-RISK PAY IS AWARDED TO ASSISTANT VICE PRESIDENTS, VICE PRESIDENTS, SENIOR VICE PRESIDENTS, EXECUTIVE VICE PRESIDENTS, AND CHIEF EXECUTIVE OFFICER BASED ON ACHIEVING OR SURPASSING SPECIFIC GOALS THAT ARE PREDETERMINED BY THE BOARD OF TRUSTEES PRIOR TO THE BEGINNING OF THE FISCAL YEAR. THE GOALS INCLUDE OUR STRATEGIC OBJECTIVES OF PERFECT CARE, SACRED ENCOUNTERS, AND HEALTHIEST COMMUNITIES, AS WELL AS FISCAL STEWARDSHIP. EACH OF THESE FACTORS IS TAKEN INTO CONSIDERATION WHEN DETERMINING THE PERCENTAGE OF THE AT-RISK-PAY.
Schedule J (Form 990) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
ST JOSEPH HEALTH SYSTEM FOUNDATION
 
Employer identification number

33-0143024
Identifier Return Reference Explanation
ORGANIZATION'S MISSION FORM 990, PART III, LINE 1 THE MISSION OF THE ST. JOSEPH HEALTH SYSTEM FOUNDATION, AS AN EXTENSION OF CHRIST'S HEALING MINISTRY, IS TO PROVIDE FUNDING AND ASSISTANCE FOR IMPROVING THE HEALTH AND WELL-BEING OF THE ECONOMICALLY POOR, AND UTILIZE THE STRENGTHS AND DIVERSITY OF OUR NEIGHBORS TO BUILD VIBRANT COMMUNITIES. THIS IS ACCOMPLISHED BY MANAGING AND ALLOCATING RESOURCES TO COMMUNITIES AND PARTNERS OF GOODWILL ENGAGED IN INNOVATIVE AND EFFECTIVE INITIATIVES TO SERVE THE COMMON GOOD.
DESCRIPTION OF PROGRAM SERVICES FORM 990, PART III, LINE 4 GROUNDED IN OUR COMMITMENT TO COMMUNITY AS A MEMBER OF THE ST. JOSEPH HEALTH SYSTEM (SJHS), THE ST. JOSEPH HEALTH SYSTEM FOUNDATION IS COMMITTED TO EXTENDING THE HEALING MINISTRY OF JESUS IN THE TRADITION OF THE SISTERS OF ST. JOSEPH OF ORANGE. WE ARE COMMITTED TO THREE SYSTEMWIDE MISSION OUTCOMES: 1) SACRED ENCOUNTERS, 2) PERFECT CARE AND 3) HEALTHIEST COMMUNITIES. MAKING EVERY ENCOUNTER WITH OUR COMMUNITY A SACRED ENCOUNTER EVERY INTERACTION WILL BE EXPERIENCED AS A SACRED ENCOUNTER. THE GOAL OF SACRED ENCOUNTER HAS A DIRECT CONNECTION TO THE OVERALL MISSION. OUR VALUE OF DIGNITY CALLS FOR US TO RESPECT EACH PERSON AS AN INHERENTLY VALUABLE MEMBER OF THE HUMAN COMMUNITY AND AS A UNIQUE EXPRESSION OF LIFE. WE STRIVE TO DO THIS BY KEEPING AT THE FOREFRONT OF OUR MINDS THE UNDERSTANDING OF THE IMPACT WE CAN HAVE ON ONE ANOTHER WITH EVERY ACTION WE TAKE. PROVIDING OUR PATIENTS IN THE COMMUNITY WITH PERFECT CARE ALL PATIENTS WILL RECEIVE PERFECT CARE. IT IS OUR ATTENTION TO DETAIL AND THE SMALLEST IMPERFECTIONS OF EACH PATIENT'S EXPERIENCE THAT DRIVES A DEEPER UNDERSTANDING AND ULTIMATELY A SUSTAINABLE APPROACH TO THE ACHIEVEMENT OF PERFECT CARE. OVER 350 YEARS AGO, THE FOUNDER OF THE CONGREGATION OF THE SISTERS OF ST. JOSEPH CRAFTED A MESSAGE IN A PROPHETIC LETTER TO SPUR THE GROWTH OF A "LITTLE DESIGN." IT WAS TO BE A NEW FORM OF ASSOCIATION OF WOMEN, WHOSE MEMBERS WOULD CONSECRATE THEIR LIVES TO GOD, LIVE TOGETHER IN SMALL GROUPS, AND COMBINE A LIFE OF PRAYER WITH AN ACTIVE MINISTRY TO THE SICK AND THE POOR. TODAY, CARRYING ON FATHER MEDAILLE'S INSPIRATION, WE ARE CULTIVATIING THE SEEDS OF A BOLD CONCEPT IN HEALTHCARE...PERFECT CARE. HIS WORDS ARE AS RELEVANT TO US TODAY AS THEY WERE FOR THE SISTERS IN 1650. "GIVE YOUR FULL ATTENTION TO THE ACTIONS YOU PERFORM, REMOVE FROM THEM THE SLIGHTEST IMPERFECTIONS, AND TRY TO OBSERVE ALL CONDITIONS NECESSARY TO MAKE THEM PERFECT. ONE ACTION DONE WELL IS WORTH A HALF DOZEN DONE HALF-HEARTEDLY." JEAN PIERRE MEDAILLE, SJ-MAXIM 14:4. MAKING THE COMMUNITIES WE SERVE THE HEALTHIEST COMMUNITIES IN THE U.S. HEALTHIEST COMMUNITIES THE COMMUNITIES WE SERVE WILL BE AMONG THE HEALTHIEST IN OUR NATION. WHAT ARE THE STEPS WE ARE TAKING TO REACH THIS GOAL? WE COLLECT AND ANALYZE DATA ON VARIOUS GEOGRAPHIC, SOCIOECONOMIC, MORBIDITY AND HEALTH RELATED BEHAVIORS IN THE COMMUNITIES WE SERVE. BY COLLECTING COMMUNITY HEALTH DATA, WE ARE ABLE TO SHARE OUR FINDINGS WITH OTHER COMMUNITY ORGANIZATIONS AND DEVELOP EVIDENCE-BASED INTIATIVES AND PROGRAMS IN THE COMMUNITIES WE SERVE.
WHO WE ARE AND WHAT WE DO   ORGANIZATIONAL COMMITMENT WE BELIEVE WE HAVE A SOCIAL RESPONSIBILITY AND A MORAL OBLIGATION TO RESPOND TO THE NEEDS OF LOW-INCOME FAMILIES AND INDIVIDUALS SERVED BY OUR MINISTRIES. IN 1986, THE ST. JOSEPH HEALTH SYSTEM (SJHS) CREATED A PLAN AND BEGAN AN EFFORT TO FURTHER ITS COMMITMENT TO NEIGHBORS IN NEED. WITH A VISION OF REACHING BEYOND THE WALLS OF ITS HEALTHCARE FACILIITES AND TRANSCENDING TRADITIONAL EFFORTS OF PROVIDING FREE CARE FOR THOSE IN NEED OF ACUTE CARE SERVICES, SJHS CREATED THE SJHS FOUNDATION TO IMPROVE THE LIVES OF LOW-INCOME INDIVIDUALS RESIDING IN ITS LOCAL COMMUNITIES. POLICY 13 IN ITS FOUNDATIONAL DOCUMENT, A VISION OF VALUES, FORMALIZES THE PROCESS BY WHICH ALL HOSPITAL MINISTRIES CONTRIBUTE 10% OF NET INCOME TO THE SJHS FOUNDATION. OVER THE LAST 24 YEARS, THE FOUNDATION HAS CONTRIBUTED OVER $175 MILLION TOWARD PROGRAMS THAT ADDRESS THE HEALTH AND WELL-BEING OF LOW-INCOME INDIVIDUALS AND FAMILIES IN AREAS SURROUNDING THE HOSPITALS. THROUGH THE FOUNDATION'S STRATEGIC GRANT MAKING PROGRAMS, SIGNIFICANT OUTCOMES HAVE BEEN ACHIEVED IN COMMUNITY HEALTH SETTINGS AND CLINICS, NONPROFIT ORGANIZATIONS, AND LOCAL SJHS HOSPITAL MINISTRIES. THE SJHS FOUNDATION HAS FOUR FUNDING INITIATIVES: DISASTER FUNDING INITIATIVE, WELLNESS AND PREVENTION INITIATIVE, COMMUNITY BUILDING INITIATIVE AND COMMUNITY CLINICS CAPACITY INITIATIVE. BELOW WE OUTLINE THE TOP THREE INTIATIVES AS MEASURED BY PROGRAM EXPENSE. WELLNESS AND PREVENTION INITIATIVE THE SJHS FOUNDATION SEEKS TO PROMOTE THE HEALTH AND WELL-BEING OF LOW-INCOME INDIVIDUALS AND FAMILIES IN AREAS SURROUNDING OUR HOSPITALS THROUGH THE WELLNESS AND PREVENTION INITIATIVE. BY FUNDING PROACTIVE PROGRAMS THROUGH THE GRANT CYCLES OF THE WELLNESS AND PREVENTION INITIATIVE, THE SJHS FOUNDATION SEEKS TO ELIMINATE THE NEED FOR CATASTROPHIC CARE AND ITS ASSOCIATED SOCIAL, EMOTIONAL AND ECONOMIC COSTS. THE TITLE OF THE INITIATIVE DESCRIBES ITS CENTRAL VISION AND STRATEGIC FOCUS. WELLNESS PROGRAMS ADDRESS THE HEALTH AND WELL-BEING OF THE INDIVIDUAL OR COMMUNITY AT RISK OR WITH A PRE-EXISTING HEALTH CONDITION. PREVENTION (I.E., PRIMARY, SECONDARY, AND TERTIARY) PROGRAMS ARE PART OF A COMPREHENSIVE STRATEGY TO IMPROVE THE HEALTH STATUS AND QUALITY OF LIFE IN OUR LOCAL COMMUNITIES WHILE REDUCING DEMAND FOR HIGH-COST MEDICAL SERVICES. PARTNERING WITH OTHER ORGANIZATIONS TO ADDRESS THE HEALTH AND WELL-BEING OF LOW-INCOME COMMUNITIES IS AT THE CORE OF THE INITIATIVE. AS IN PREVIOUS GRANT CYCLES, SJHS FOUNDATION SEEKS PROPOSALS THAT ADDRESS THE HEALTH AND WELL-BEING OF LOW-INCOME COMMUNITIES IN ALL AREAS OF HEALTH. AMOUNT GRANTED IN FY 2011: $2,423,785 HEALTHY FOR LIFE INITIATIVE SJHS FOUNDATION CONTINUED TO SUPPORT THE SYSTEMWIDE EXPANSION OF OUR HEALTHY FOR LIFE CAMPAIGN, A COMPREHENSIVE SOCIAL AND HEALTHCARE OUTREACH CAMPAIGN DESIGNED TO FIGHT THE CHILDHOOD OBESITY EPIDEMIC THAT PLAGUES AN ESTIMATED NINE MILLION AMERICAN CHILDREN. HEALTHY FOR LIFE INCLUDES A SCHOOL-BASED PREVENTION/INTERVENTION PHYSICAL EDUCATION PROGRAM AS WELL AS A NUTRITION AND LIFESTYLE COMPONENT. WITH AN EMPHASIS ON REACHING AT-RISK YOUTH AND THEIR COMMUNITIES, THE PROGRAM'S GOAL IS TO PROVIDE PARENTS AND CHILDREN WITH THE TOOLS AND KNOWLEDGE TO HELP THEM CHOOSE A HEALTHIER LIFESTYLE. IN FISCAL YEAR 2011, MORE THAN 100 SCHOOLS AND 3,702 STUDENTS WERE ABLE TO PARTICIPATE IN HEALTHY FOR LIFE, A FREE, CURRICULUM BASED PROGRAM LED BY A PHYSICAL EDUCATION TEACHER AT THE MIDDLE AND HIGH SCHOOL LEVELS AND THE CLASS TEACHER AT THE PRESCHOOL AND ELEMENTARY SCHOOL LEVELS. THE PROGRAM INCLUDES INCREASED PHYSICAL ACTIVITY INTENSITY LESSONS, STRENGTH/WEIGHT TRAINING SESSIONS, KICKBOXING CLASSES AT THE ELEMENTARY, MIDDLE AND HIGH SCHOOL LEVELS AND HEALTHY NUTRITION EDUCATION INFORMATION. SINCE LAUNCHING THE HEALTHY FOR LIFE CAMPAIGN, APPROXIMATELY 39% OF PARTICIPANTS WERE ASSESSED AS OVERWEIGHT OR OBESE. BY THE END OF THE 2011 SCHOOL YEAR, 9.75% OF THOSE STUDENTS IMPROVED THEIR WEIGHT STATUS. THE PROPORTION OF STUDENTS' WAIST CIRCUMFERENCE DECREASED FROM 18.6% AT BASELINE TO 12.1% AT YEAR-END. THE PROPORTION OF STUDENTS WITH LOW SELF-ESTEEM DECREASED FROM 10% TO 9% DURING THE SAME PERIOD. BY YEAR END, 88% OF STUDENTS REPORTED EXERCISING AT LEAST THREE TO SIX TIMES A WEEK AND 85% OF STUDENTS STATED THAT THEY EAT VEGETABLES THREE TO SIX TIMES A WEEK AS WELL AS DECREASED THEIR JUNK FOOD INTAKE. AMOUNT GRANTED IN FY11: $950,900 DISASTER RELIEF FUNDING ST. JOSEPH HEALTH SYSTEM FOUNDATION CONSIDERS NEEDS ARISING FROM THE OCCURRENCE OF DISASTER AND UNFORESEEN EMERGENCY NEEDS NATIONALLY AND THROUGHOUT THE WORLD. THROUGH RESPONSIVE GRANTMAKING, THE FOUNDATION WORKS TO ADDRESS THE POVERTY AND SUFFERING THAT OFTEN FOLLOW CATASTROPHIC EVENTS. DISASTER RELIEF FUNDING WAS PROVIDED TO U.S.-BASED, NON PROFIT ORGANIZATIONS THAT PROVIDE RELIEF EFFORTS IN THE U.S. AND ABROAD. THESE ORGANIZATIONS HAVE PROVEN EXPERTISE IN RECONSTRUCTION, DEVELOPMENT AID AND IN REBUILDING COMMUNITIES. AMOUNT GRANTED IN FY 2011: $250,000 PEOPLE AROUND THE WORLD WERE DEVASTATED BY THE EFFECTS OF CATASTROPHIC NATURAL DISASTERS IN JAPAN AND PAKISTAN DURING FISCAL YEAR 2011. THE SJHS FOUNDATION RESPONDED QUICKLY TO PROVIDE IMMEDIATE RELIEF TO THOSE IN NEED. - JAPANESE TSUNAMI & EARTHQUAKE RELIEF JAPAN WAS STRUCK BY THE MOST POWERFUL EARTHQUAKE TO HIT THE ISLAND NATION IN RECORDED HISTORY LAST MARCH. THE TSUNAMI THAT FOLLOWED THIS DISASTER CAUSED WIDESPREAD DEVASTATION AND LED TO MORE THAN 10,000 KILLED OR MISSING PEOPLE. SJHS FOUNDATION RESPONDED BY GIVING THE AMERICAN RED CROSS A GRANT TO PROVIDE IMMEDIATE EMERGENCY RELIEF FOR THE PEOPLE AFFECTED BY THESE CATASTROPHIC DISASTERS. - PAKISTAN FLOOD RELIEF HEAVY MONSOON RAINS LAST JULY CAUSED MASSIVE FLOODING IN PAKISTAN LEAVING APPROXIMATELY ONE-FIFTH OF THE COUNTRY'S LAND AREA UNDERWATER. THE DISASTER AFFECTED NEARLY 20 MILLION PEOPLE THROUGH EXTENSIVE DAMAGE TO PROPERTY, LIVELIHOOD, CROPS AND INFRASTRUCTURE. SJHS FOUNDATION'S CONTRIBUTION WAS ALLOCATED TO INTERNATIONAL MEDICAL CORPS, WHICH SUPPORTED EMERGENCY MEDICAL CLINICS IN THE MANY REGIONS OF PAKISTAN AFFECTED BY THE FLOODS. - TORNADO IN JOPLIN, MISSOURI IN MAY 2011, THE LARGEST TORNADO IN U.S. HISTORY STRUCK JOPLIN, MISSOURI, CAUSING WIDESPREAD DAMAGE AND DESTRUCTION AND THE DEATHS OF AT LEAST 151 PEOPLE. AN ESTIMATED ONE THIRD OF THE BUILDINGS IN THE TOWN WERE DESTROYED, INCLUDING HOMES, HOSPITALS, SCHOOLS AND CHURCHES, WITH DEBRIS STREWN THROUGHOUT THE COUNTY. SJHS FOUNDATION RESPONDED TO THIS DISASTER WITH A FINANCIAL ALLOCATION TO MERCY HOUSING, A NONPROFIT ORGANIZATION THAT DEVELOPS AFFORDABLE HOUSING FOR LOW-INCOME PEOPLE. FUNDING HELPED PROVIDE HOUSING FOR DISPLACED RESIDENTS AND TORNADO RECOVERY EFFORTS. - HAITI EARTHQUAKE RELIEF SJHS FOUNDATION CONTINUED TO SUPPORT RECOVERY AND REBUILDING EFFORTS IN HAITI, WHICH HAVE BEEN ONGOING SINCE THE NATION'S 2010 CATASTROPHIC EARTHQUAKES. DURING FISCAL YEAR 2011, SJHS FOUNDATION ALLOCATED AN ADDITIONAL $100,000 FOR SUSTAINED IMPROVEMENT AND SUPPORT WHICH FUNDED THE FOLLOWING PROGRAMS: SJHS FOUNDATION PROVIDED FUNDS TO OPERATION USA TO SUPPORT RECOVERY EFFORTS IN THE REGION, INCLUDING THE ESTABLISHMENT OF A FEEDING PROGRAM AT A 400-STUDENT PUBLIC SCHOOL IN JACMEL, HAITI AND THE REBUILDING OF THE DESGRANGES HEALTH CENTER OF PETIT GOAVE, WHICH PROVIDES HEALTH SERVICES TO 60,000 PEOPLE. SJHS FOUNDATION PROVIDED FUNDS TO SUPPORT A CHOLERA EPIDEMIC RESPONSE PROJECT MANAGED BY THE UNIVERSITY OF MIAMI MILLER SCHOOL OF MEDICINE. THROUGH THIS PROJECT, THE UNIVERSITY WILL UTILIZE COMMUNITY HEALTH WORKERS TO IDENTIFY CASES OF CHOLERA AND EDUCATE COMMUNITY MEMBERS ON PREVENTING THE SPREAD OF CHOLERA. TREATMENT CENTERS WILL BE ESTABLISHED TO PROVIDE LIFE-SAVING MEDICAL CARE TO THOSE AFFECTED BY CHOLERA. FOR MORE INFORMATION ON THE SJHS FOUNDATION GO TO: HTTP://WWW.STJHS.ORG/SJHSPROGRAMS/FOUNDATION FOR MORE INFORMATION ON THE ST. JOSEPH HEALTH SYSTEM FOUNDATION GO TO: WWW.STJOE.ORG
DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PART VI, QUESTION 6 ST. JOSEPH HEALTH SYSTEM IS THE SOLE CORPORATE MEMBER OF ST. JOSEPH HEALTH SYSTEM FOUNDATION.
DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS FORM 990, PART VI, QUESTION 7A ST. JOSEPH HEALTH SYSTEM FOUNDATION HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBERS RESERVE THE RIGHT TO APPOINT TRUSTEES TO THE ST. JOSEPH HEALTH SYSTEM FOUNDATION BOARD. ALL TRUSTEE APPOINTMENTS COME FROM THE ST. JOSEPH HEALTH SYSTEM FOUNDATION BOARD AS NOMINATIONS AND MUST BE APPROVED BY THE ST. JOSEPH SYSTEM, AS THE CORPORATE MEMBER, AND THE ST. JOSEPH HEALTH SYSTEM MINISTRY, AS THE ORGANIZATIONAL SPONSOR.
DESCR CLASSES OF PERSONS, DECISIONS REQUIRING APPR & TYPE OF VOTING RIGHTS FORM 990, PART VI, QUESTION 7B THE RESERVED RIGHTS IN OUR TIERED GOVERNANCE STRUCTURE CONTEMPLATE APPROVAL BY THE ST. JOSEPH HEALTH SYSTEM MEMBER OF FINANCING, BUDGETS, UNBUDGETED EXPENDITURES OF DEFINED AMOUNTS, STRATEGIC PLAN, APPOINTMENT OF AUDITORS, CREATION OR INVESTMENT IN A LEGALLY RECOGNIZED ENTITY, JOINT VENTURES, PURPOSES, SALE OR DISPOSITION OF REAL PROPERTY, MERGER OR SALE OF SUBSTANTIALLY ALL ASSETS, APPOINTMENT AND REMOVAL OF TRUSTEES, ADOPTION OR AMENDMENT OF ARTICLES OR BYLAWS.
DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 FORM 990, PART VI, QUESTION 11B THE FORM 990 IS PREPARED BY THE FINANCE DEPARTMENT BASED ON INFORMATION RECEIVED FROM VARIOUS DEPARTMENTS OF THE ORGANIZATION AS APPLICABLE. THE FORM 990 IS THEN REVIEWED BY AN OFFICER (S) OF THE ORGANIZATION. A COPY OF THE FORM 990 FILING IS THEN DISTRIBUTED TO ALL VOTING MEMBERS OF THE BOARD FOR THE SPRING MEETING. DURING THE BOARD MEETING, MANAGEMENT PRESENTS AND DISCUSSES CERTAIN DISCLOSURES AND INFORMATION INCLUDED IN THE 990 FORM.
DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST FORM 990, PART VI, QUESTION 12C OFFICERS, TRUSTEES, AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE ANNUALLY ON THE CONFLICT OF INTEREST DISCLOSURE FORM THE EXISTENCE AND NATURE OF ANY ACTUAL, APPARENT, OR POTENTIAL CONFLICT OF INTEREST HE/SHE MAY HAVE. ADDITIONALLY, DISCLOSURES SHALL BE MADE PROMPTLY ANYTIME AN ACTUAL, APPARENT OR POTENTIAL CONFLICT OF INTEREST ARISES AND BEFORE THE CONSUMMATION OF ANY CONTRACT, TRANSACTION OR ARRANGEMENT THAT IS THE SUBJECT OF THE POTENTIAL CONFLICT OF INTEREST. WHEN A CONFLICT OF INTEREST IS IDENTIFIED, SUCH CONFLICT IS DISCLOSED TO THE ST. JOSEPH HEALTH SYSTEM FOUNDATION BOARD. IF THE CONFLICT INVOLVES A MEMBER OF THE BOARD, THE REMAINING MEMBERS WILL REVIEW THE MATTER AND DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. THE OFFICER, TRUSTEE, OR KEY EMPLOYEE MAY NOT BE PRESENT DURING ANY MEETING IN WHICH THE BOARD CONDUCTS ITS EVALUATION, EXCEPT TO ANSWER QUESTIONS AS MAY BE NECESSARY. ONCE ALL NECESSARY INFORMATION HAS BEEN OBTAINED, THE BOARD CONDUCTS ITS EVALUATION AND FORWARDS ITS FINDINGS AND RECOMMENDATIONS TO THE SJHS CHIEF COMPLIANCE OFFICER. IF THE BOARD DETERMINES AN UNRESOLVED CONFLICT OF INTEREST EXISTS, THE BOARD WILL EVALUATE AND RECOMMEND CONFLICT MITIGATION STRATEGIES. THE SJHS CHIEF COMPLIANCE OFFICER IN CONSULTATION WITH SJHS GENERAL COUNSEL WILL REVIEW THE BOARD FINDINGS, RECOMMENDATIONS, AND MITIGATION STRATEGIES AND PRESENT RECOMMENDATIONS TO THE BOARD FOR DISCUSSION AND VOTE.
WHISTLEBLOWER, DOCUMENT RETENTION AND DESTRUCTION POLICY FORM 990, PART VI, QUESTION 13 AND 14 THE ORGANIZATION WILL PRESENT THE POLICIES TO THE BOARD IN THEIR NEXT QUARTERLY MEETING IN APRIL 2012 FOR ADOPTION. THE POLICIES ARE EXPECTED TO BE ADOPTED FOR FY 2012.
OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN FORM 990, PART VI, QUESTION 15A THE CHIEF EXECUTIVE OFFICER OF ST. JOSEPH HEALTH SYSTEM FOUNDATION (SJHSF) IS NOT COMPENSATED BY SJHSF OR ANY OTHER RELATED OR UNRELATED ORGANIZATION FOR HER SERVICES AS CEO OF SJHSF.
OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN FORM 990, PART VI, QUESTION 15B ONE OF THE OFFICERS IS PAID BY A RELATED ORGANIZATION, ST. JOSEPH HEALTH SYSTEM. THE EXECUTIVE COMPENSATION PROCESS AT ST. JOSEPH HEALTH SYSTEM IS ADMINISTERED BY A COMMITTEE OF INDEPENDENT TRUSTEES. THEY FOLLOW A BOARD-APPROVED CHARTER AND OVERALL EXECUTIVE COMPENSATION PHILOSOPHY. THE CHARTER EMPOWERS THE SJHS BOARD WORKLIFE COMMITTEE TO ADMINISTER THE EXECUTIVE COMPENSATION PROGRAM AND PROCESS ON BEHALF OF THE FULL BOARD OF TRUSTEES OF SJHS. OVERALL, THE PHILOSOPHY IS INTENDED TO REWARD A BROAD SPECTRUM OF HIGH ORGANIZATIONAL AND INDIVIDUAL PERFORMANCE EXPECTATIONS, AS WELL AS THE RETENTION OF KEY MANAGEMENT TALENT. THE SJHS EXECUTIVE COMPENSATION PHILOSOPHY DEFINES THE MARKET FOR ADMINISTERING COMPENSATION AS A COMPARABLE SET OF NOT-FOR-PROFIT AND FOR-PROFIT HEALTH CARE DELIVERY SYSTEMS. SJHS PROVIDES COMPENSATION TO ITS SENIOR EXECUTIVES IN THE FORM OF BASE SALARY, AN ANNUAL INCENTIVE PROGRAM, AND BENEFITS. TO FULFILL THEIR RESPONSIBILITY, THE COMMITTEE REGULARLY REVIEWS INFORMATION FROM MULTIPLE SOURCES OF MARKET DATA. THEY USE THIS INFORMATION TO SUPPORT THEIR DECISIONS REGARDING ONGOING EFFECTIVENESS AND ADMINISTRATION OF THE PROGRAM. THE WORKLIFE COMMITTEE IS COMPRISED OF SEVERAL INDEPENDENT MEMBERS OF THE BOARD. THEY MEET FOUR TIMES A YEAR AND ALL CRITICAL DECISIONS ARE MADE DURING THE WORKLIFE COMMITTEE MEETINGS OR IN EXECUTIVE SESSION. THESE DECISIONS ARE DOCUMENTED IN DETAILED MINUTES AND APPROVED IN SUBSEQUENT MEETINGS. THE COMMITTEE IS EMPOWERED TO ENGAGE OUTSIDE COUNSEL AND CONSULTING SUPPORT AS NEEDED. THE WORKLIFE COMMITTEE PERFORMED ITS LAST COMPENSATION REVIEW FOR ASSISTANT VICE PRESIDENTS, VICE PRESIDENTS, SENIOR VICE PRESIDENTS, EXECUTIVE VICE PRESIDENTS, AND THE CHIEF EXECUTIVE OFFICER IN SEPTEMBER 2011.
AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC FORM 990, PART VI, QUESTION 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE SJHS COMMUNITY BENEFIT REPORTS, FINANCIAL REPORTS, AND PHILANTHROPY REPORTS ARE ALSO AVAILABLE ON THE SJHS INTERNET SITE.
HOURS DEVOTED TO RELATED ORGANIZATIONS FORM 990, PART VII SISTER JAYNE HELMLINGER SERVES ON THE BOARD OF ST. JOSEPH HEALTH SYSTEM FOUNDATION (SJHSF), THE RELATED TAX EXEMPT ORGANIZATIONS ST. JOSEPH HOSPITAL OF EUREKA (SJE) AND REDWOOD MEMORIAL HOSPITAL (RMH). SHE IS ALSO AN OFFICER OF THE TAX-EXEMPT PARENT, ST. JOSEPH HEALTH SYSTEM (SJHS). SHE DEVOTES 50 HOURS PER WEEK TO SJHS AND TWO HOURS PER WEEK TO EACH HOSPITAL. TOM MAHOWALD SERVES ON THE BOARD AND IS AN OFFICER OF SJHSF AS WELL AS AN EMPLOYEE OF SJHS. HE DEVOTES 50 HOURS PER WEEK TO SJHS. SISTER MARIAN SCHUBERT SERVES ON THE BOARD OF SJHSF, SJE, RMH, AND IS AN OFFICER OF THE RELATED TAX EXEMPT ORGANIZATION QUEEN OF THE VALLEY MEDICAL CENTER (QVMC). SHE DEVOTES 50 HOURS PER WEEK TO QVMC AND TWO HOURS PER WEEK TO EACH HOSPITAL. DEBORAH PROCTOR SERVES ON THE BOARD OF SJHSF AND SJE. SHE IS ALSO AN EMPLOYEE OF SJHS. SHE DEVOTES 50 HOURS PER WEEK TO SJHS AND TWO HOURS PER WEEK TO SJE. JO SANDERSFELD SERVES ON THE BOARD OF SJHSF AND IS AN EMPLOYEE OF THE RELATED ORGANIZATION, SANTA ROSA MEMORIAL HOSPITAL (SRMH). SHE DEVOTES 50 HOURS PER WEEK TO SRMH. JASON BARKER IS A FORMER OFFICER OF SJHSF AND IS AN EMPLOYEE OF THE RELATED TAX-EXEMPT ORGANIZATION, ST. MARY MEDICAL CENTER (SMMC). HE DEVOTES 50 HOURS PER WEEK TO SMMC.
MANAGEMENT FEES FORM 990, PART IX, LINE 11A A MANAGEMENT FEE PAID TO ST. JOSEPH HEALTH SYSTEM (SJHS) INCLUDES TIME FOR AN EXECUTIVE DIRECTOR, GRANT MANAGER AND A PROGRAM OFFICER. ALL ARE ON THE PAYROLL OF SJHS.
OTHER CHANGES IN NET ASSETS OR FUND BALANCE FORM 990, PART XI, LINE 5 UNREALIZED GAIN OF $5,065,232 NOT INCLUDED IN REVENUE.
OVERSIGHT OF SELECTION PROCESS FORM 990, PART XII, LINE 2C THE ST. JOSEPH HEALTH SYSTEM BOARD APPROVES THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
ST JOSEPH HEALTH SYSTEM FOUNDATION
 
Employer identification number

33-0143024
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN 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 organization
Yes No
(1) CAMINO HEALTH CENTER

30300 CAMINO CAPISTRANO

SAN JUAN CAPISTRANO,CA92675
33-0574214 		HEALTHCARE CA 501(C)(3) 7 MHRMC
 
 
 
(2) COVENANT HEALTH PARTNERS

3615 19TH STREET

LUBBOCK,TX79410
61-1573313 		HEALTHCARE TX 501(C)(3) 11, I CHS
 
 
 
(3) COVENANT HEALTH SYSTEM

3615 19TH STREET

LUBBOCK,TX79410
75-2765566 		HEALTHCARE TX 501(C)(3) 3 SJHS
 
 
 
(4) COVENANT HEALTH SYSTEM FOUNDATION

4000 24TH STREET

LUBBOCK,TX79410
75-2897026 		HEALTHCARE TX 501(C)(3) 7 CHS
 
 
 
(5) COVENANT MEDICAL GROUP

3420 22ND PLACE

LUBBOCK,TX79410
75-2743883 		HEALTHCARE TX 501(C)(3) 3 CHS
 
 
 
(6) HOME CARE PARTNERS

1165 MONTGOMERY DR

SANTA ROSA,CA95405
68-0318656 		INACTIVE CA 501(C)(3) 3 SRMH
 
 
 
(7) HOSPICE OF LUBBOCK

1102 SLIDE ROAD

LUBBOCK,TX79414
75-2133781 		HEALTHCARE TX 501(C)(3) 9 CHS
 
 
 
(8) LUBBOCK METHODIST HOSPITAL FOUNDATION

3615 19TH STREET

LUBBOCK,TX79410
75-2220963 		HEALTHCARE TX 501(C)(3) 7 CHS
 
 
 
(9) METHODIST CHILDREN'S HOSPITAL

3610 21ST STREET

LUBBOCK,TX79410
75-2428911 		HEALTHCARE TX 501(C)(3) 3 CHS
 
 
 
(10) METHODIST HOSPITAL LEVELLAND

1900 COLLEGE AVENUE

LEVELLAND,TX79336
75-2246348 		HEALTHCARE TX 501(C)(3) 3 CHS
 
 
 
(11) METHODIST HOSPITAL PLAINVIEW

2601 DIMMITT ROAD

PLAINVIEW,TX79072
75-2426010 		HEALTHCARE TX 501(C)(3) 3 CHS
 
 
 
(12) MISSION HOSPITAL REG MED CTR FDN

27700 MEDICAL CENTER ROAD

MISSION VIEJO,CA92691
33-0406118 		HEALTHCARE CA 501(C)(3) 7 MHRMC
 
 
 
(13) MISSION HOSPITAL REGIONAL MEDICAL CENTER

27700 MEDICAL CENTER ROAD

MISSION VIEJO,CA92691
95-1643360 		HEALTHCARE CA 501(C)(3) 3 SJHS
 
 
 
(14) QUEEN OF THE VALLEY MEDICAL CENTER

1000 TRANCAS STREET

NAPA,CA94558
94-1243669 		HEALTHCARE CA 501(C)(3) 3 SJHS
 
 
 
(15) REDWOOD MEMORIAL FOUNDATION

3300 RENNER DRIVE

FORTUNA,CA95540
94-2779313 		FOUNDATION CA 501(C)(3) 7 RMH
 
 
 
(16) REDWOOD MEMORIAL HOSPITAL

3300 RENNER DRIVE

FORTUNA,CA95540
94-1384665 		HEALTHCARE CA 501(C)(3) 3 SJHS
 
 
 
(17) SANTA ROSA MEMORIAL HOSPITAL

1165 MONTGOMERY DRIVE

SANTA ROSA,CA95405
94-1231005 		HEALTHCARE CA 501(C)(3) 3 SJHS
 
 
 
(18) SISTERS OF ST JOSEPH OF ORANGE

480 S BATAVIA

ORANGE,CA92868
95-1643383 		RELIGIOUS ORG CA 501(C)(3) 1 NA
 
 
 
(19) SRM ALLIANCE HOSPITAL SERVICES

400 NORTH MCDOWELL BLVD

PETALUMA,CA94954
68-0395200 		HEALTHCARE CA 501(C)(3) 3 SRMH
 
 
 
(20) ST JOSEPH HEALTH FDN OF N CALIFORNIA

PO BOX 552

SANTA ROSA,CA95405
68-0338070 		INACTIVE CA 501(C)(3) 11, I SRMH
 
 
 
(21) ST JOSEPH HEALTH MINISTRY

500 S MAIN STREET SUITE 400

ORANGE,CA92868
27-1666576 		RELIGIOUS ORG CA 501(C)(3) 1 SSJO
 
 
 
(22) ST JOSEPH HEALTH SYSTEM

500 S MAIN STREET SUITE 700

ORANGE,CA92868
95-3589356 		HEALTHCARE CA 501(C)(3) 11, I SJHM
 
 
 
(23) ST JOSEPH HOME CARE NETWORK

170 PROFESSIONAL CENTER DR B

ROHNERT PARK,CA94928
68-0331084 		HEALTHCARE CA 501(C)(3) 9 SJHS
 
 
 
(24) ST JOSEPH HOSPITAL OF EUREKA

2700 DOLBEER STREET

EUREKA,CA95501
94-1156596 		HEALTHCARE CA 501(C)(3) 3 SJHS
 
 
 
(25) ST JOSEPH HOSPITAL OF ORANGE

1100 WEST STEWART DRIVE

ORANGE,CA92868
95-1643359 		HEALTHCARE CA 501(C)(3) 3 SJHS
 
 
 
(26) ST JUDE HOSPITAL YORBA LINDA

279 E IMPERIAL HWY 750

FULLERTON,CA92835
33-0185031 		HEALTHCARE CA 501(C)(3) 3 SJHS
 
 
 
(27) ST JUDE HOSPITAL INC

101 EAST VALENCIA MESA DRIVE

FULLERTON,CA92635
95-1643325 		HEALTHCARE CA 501(C)(3) 3 SJHS
 
 
 
(28) ST JUDE MEMORIAL FOUNDATION

1440 N HARBOR BLVD 200

FULLERTON,CA92835
95-3607229 		HEALTHCARE CA 501(C)(3) 11, I SJMC
 
 
 
(29) ST MARY MEDICAL CENTER

18300 HIGHWAY 18

APPLE VALLEY,CA92307
95-1914489 		HEALTHCARE CA 501(C)(3) 3 SJHS
 
 
 
(30) ST MARY OF THE PLAINS HOSPITAL FDN

4000 24TH STREET

LUBBOCK,TX79410
75-1653181 		HEALTHCARE TX 501(C)(3) 7 CHS
 
 
 
(31) TALLER SAN JOSE

801 NORTH BROADWAY

SANTA ANA,CA92701
59-3816355 		WORKFORCE DEV CA 501(C)(3) 2 SSJO
 
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
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
Yes No Yes No
(1) ST JOSEPH HLTH SYS HOME HLTH

 
 
HOME HEALTH CA NA
  		N/A 0 0   No 0   No 0 %
(2) ST JOSEPH HLTH SYS HOME CARE

 
 
HOME HEALTH CA NA
  		N/A 0 0   No 0   No 0 %
(3) METHODIST DIAGNOSTIC IMAGING

 
 
HEALTHCARE SVCS TX NA
  		N/A 0 0   No 0   No 0 %
(4) SHA LLC

 
 
HEALTHCARE SVCS TX NA
  		N/A 0 0   No 0   No 0 %
(5) LUBBOCK SURGERY CENTER LTD

 
 
HEALTHCARE SVCS TX NA
  		N/A 0 0   No 0   No 0 %
(6) COVENANT LONG-TERM CARE LP

 
 
HEALTHCARE SVCS TX NA
  		N/A 0 0   No 0   No 0 %
(7) HERITAGE INVESTMENT GROUP

 
 
INVESTMENT CA NA
  		N/A 0 0   No 0   No 0 %
(8) MISSION AMBULATORY SURGICENTER

 
 
HEALTHCARE SVCS CA NA
  		N/A 0 0   No 0   No 0 %
(9) COMPREHENSIVE IMAGING PARTNERS

 
 
HEALTHCARE SVCS CA NA
  		N/A 0 0   No 0   No 0 %
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
(1) ST JOSEPH PROF SVCS ENTERPRISES INC
500 S MAIN STREET SUITE 700
ORANGE,CA92868
33-0155323 		HEALTHCARE SVCS CA NA
  		C-CORP 0 0 0 %
(2) AMERICAN UNITY GROUP LTD
58 PAR-LA-VILLE ROAD
HAMILTON HM HX    
BD
CAPTIVE INSURANCE BD NA
  		C-CORP 0 0 0 %
(3) ALLIANCE PHYSICIAN SERVICES
 
 
INACTIVE CA NA
  		C CORP 0 0 0 %
(4) MISSION VIEJO MEDICAL VENTURES
27800 MEDICAL CENTER RD 354
MISSION VIEJO,CA92691
33-0212905 		HEALTHCARE SVCS CA NA
  		C CORP 0 0 0 %
(5) MISSION MEDICAL CENTER ASSOCIATION
27800 MEDICAL CENTER RD 354
MISSION VIEJO,CA92691
33-0201044 		HEALTHCARE SVCS CA NA
  		C CORP 0 0 0 %
(6) ST JOSEPH YORBA PARK
 
 
INACTIVE CA NA
  		C CORP 0 0 0 %
(7) LUBBOCK METHODIST HOSPITAL SVCS
PO BOX 1201
LUBBOCK,TX79410
75-2118585 		HEALTHCARE SVCS TX NA
  		C CORP 0 0 0 %
(8) LUBBOCK METHODIST HOSP PRACTICE MGMT
2107 OXFORD STREET SUITE 300
LUBBOCK,TX79410
75-2578995 		INACTIVE TX NA
  		C CORP 0 0 0 %
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
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 (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
2
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 other organization 		(b)
Transaction
type(a-r) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) CAMINO HEALTH CENTER

 B 75,000  
(2) REDWOOD MEMORIAL HOSPITAL

 B 250,000  
(3) ST JOSEPH HOSPITAL OF EUREKA

 B 250,000  
(4) ST MARY MEDICAL CENTER

 B 862,657  
(5) SANTA ROSA MEMORIAL HOSPITAL

 B 992,438  
(6) QUEEN OF THE VALLEY MEDICAL CENTER

 B 1,320,460  
(7) COVENANT HEALTH SYSTEM

 B 1,928,339  
(8) MISSION HOSPITAL REGIONAL MEDICAL CENTER

 B 2,052,456  
(9) ST JOSEPH HOSPITAL OF ORANGE

 B 2,347,290  
(10) ST JUDE HOSPITAL INC

 B 3,514,320  
(11) REDWOOD MEMORIAL HOSPITAL

 C 308,900  
(12) ST JOSEPH HOSPITAL OF EUREKA

 C 350,400  
(13) QUEEN OF THE VALLEY MEDICAL CENTER

 C 1,563,900  
(14) ST MARY MEDICAL CENTER

 C 1,636,600  
(15) SANTA ROSA MEMORIAL HOSPITAL

 C 1,864,800  
(16) ST JOSEPH HOSPITAL OF ORANGE

 C 2,651,100  
(17) COVENANT HEALTH SYSTEM

 C 3,555,500  
(18) MISSION HOSPITAL REGIONAL MEDICAL CENTER

 C 4,065,800  
(19) ST JUDE HOSPITAL INC

 C 6,439,200  
(20) ALLIANCE PHYSICIAN SERVICES

   0  
(21) AMERICAN UNITY GROUP LTD

   0  
(22) COMPREHENSIVE IMAGING PARTNERS OF OC LLC

   0  
(23) COVENANT HEALTH PARTNERS

   0  
(24) COVENANT HEALTH SYSTEM FOUNDATION

   0  
(25) COVENANT LONG-TERM CARE LP

   0  
(26) COVENANT MEDICAL GROUP

   0  
(27) HERITAGE INVESTMENT GROUP I LLC

   0  
(28) HOME CARE PARTNERS

   0  
(29) HOSPICE OF LUBBOCK

   0  
(30) LUBBOCK METHODIST HOSPITAL FOUNDATION

   0  
(31) LUBBOCK METHODIST HOSPITAL PRACTICE MGMT

   0  
(32) LUBBOCK METHODIST HOSPITAL SERVICES

   0  
(33) LUBBOCK SURGERY CENTER LTD

   0  
(34) METHODIST CHILDREN'S HOSPITAL

   0  
(35) METHODIST DIAGNOSTIC IMAGING

   0  
(36) METHODIST HOSPITAL LEVELLAND

   0  
(37) METHODIST HOSPITAL PLAINVIEW

   0  
(38) MISSION AMBULATORY SURGICENTER

   0  
(39) MISSION HOSPITAL REG MED CTR FDN

   0  
(40) MISSION MEDICAL CENTER ASSOCIATION

   0  
(41) MISSION VIEJO MEDICAL VENTURES

   0  
(42) REDWOOD MEMORIAL FOUNDATION

   0  
(43) SHA LLC

   0  
(44) SRM ALLIANCE HOSPITAL SERVICES

   0  
(45) ST JOSEPH HEALTH FDN OF N CALIFORNIA

   0  
(46) ST JOSEPH HEALTH SYSTEM HOME CARE SERVICES

   0  
(47) ST JOSEPH HEALTH SYSTEM HOME HEALTH AGENCY

   0  
(48) ST JOSEPH HOME CARE NETWORK

   0  
(49) ST JOSEPH PROF SVCS ENTERPRISES INC

   0  
(50) ST JOSEPH YORBA PARK

   0  
(51) ST JUDE HOSPITAL YORBA LINDA

   0  
(52) ST JUDE MEMORIAL FOUNDATION

   0  
(53) ST MARY OF THE PLAINS HOSPITAL FDN

   0  
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
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) 		(d)
Are all
partners
section
501(c)(3)
organizations? 		(e)
Share of
end-of-year
assets 		(f)
Disproprtionate allocations? 		(g)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065) 		(h)
General or
managing
partner?
Yes No Yes No Yes No






























Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS A PARTNERSHIP SCHEDULE R, PART III ST. JOSEPH HEALTH SYSTEM HOME HEALTH AGENCY EIN: 33-0282945 ADDRESS: 1845 W. ORANGEWOOD AVENUE, STE. 200 ORANGE, CA 92868-2012 ST. JOSEPH HEALTH SYSTEM HOME CARE SERVICES EIN: 33-0307672 ADDRESS: 1845 W. ORANGEWOOD AVENUE, STE. 100 ORANGE, CA 92868-2012 METHODIST DIAGNOSTIC IMAGING EIN: 75-2343261 ADDRESS: 4005 24TH STREET LUBBOCK, TX 79410 SHA, LLC EIN: 75-2569094 ADDRESS: 12940 NORTH HIGHWAY 183 AUSTIN, TX 78750 LUBBOCK SURGERY CENTER, LTD. EIN: 75-2177401 ADDRESS: 4000 24TH STREET LUBBOCK, TX 79410 COVENANT LONG-TERM CARE, LP EIN: 20-5033419 ADDRESS: 4000 24TH STREET LUBBOCK, TX 79410 HERITAGE INVESTMENT GROUP I, LLC EIN: 27-1000061 ADDRESS: 500 S. MAIN STREET STE. 1000 ORANGE, CA 92868 MISSION AMBULATORY SURGICENTER, LTD EIN: 33-0355575 ADDRESS: 27800 MEDICAL CENTER ROAD, STE. 362 MISSION VIEJO, CA 92691 COMPREHENSIVE IMAGING PARTNERS OF ORANGE COUNTY, LLC EIN: 26-4591502 ADDRESS: ONE CITY BOULEVARD WEST, SUITE 1100 ORANGE, CA 92868
Additional Data


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