Form990-PF

Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
bulletDo not enter social security numbers on this form as it may be made public.
bulletGo to www.irs.gov/Form990PF for instructions and the latest information.
OMB No. 1545-0052
2019
Open to Public Inspection
For calendar year 2019, or tax year beginning 11-01-2017 , and ending 10-31-2018
Name of foundation
POTOMAC HEALTH FOUNDATION
 
Number and street (or P.O. box number if mail is not delivered to street address)2296 OPITZ BOULEVARD NO 200
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
WOODBRIDGE, VA22191
A Employer identification number

52-1340920
B Telephone number (see instructions)

(703) 523-0620
C bullet
G Check all that apply:

D 1. Foreign organizations, check here............. bullet
2. Foreign organizations meeting the 85%
test, check here and attach computation ... bullet
E bullet
H Check type of organization:
F bullet
I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)bullet$107,675,103J Accounting method:
 
(Part I, column (d) must be on cash basis.)
Part I Analysis of Revenue and Expenses (The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).) (a) Revenue and
expenses per
books 		(b) Net investment
income 		(c) Adjusted net
income 		(d) Disbursements
for charitable
purposes
(cash basis only)
Revenue 1 Contributions, gifts, grants, etc., received (attach schedule) 4,090
2 Check bullet.............
3 Interest on savings and temporary cash investments 335 335  
4 Dividends and interest from securities... 4,238,072 4,521,409  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 1,988,727
b Gross sales price for all assets on line 6a 22,779,362
7 Capital gain net income (from Part IV, line 2)... 1,988,727
8 Net short-term capital gain.........  
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule).......      
12 Total. Add lines 1 through 11........ 6,231,224 6,510,471  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 132,945 19,942   113,003
14 Other employee salaries and wages...... 157,587 0   113,115
15 Pension plans, employee benefits....... 61,012 4,188   56,824
16a Legal fees (attach schedule)......... Click to see attachment 3,576 0   3,080
b Accounting fees (attach schedule)....... Click to see attachment 51,326 0   46,806
c Other professional fees (attach schedule).... Click to see attachment 638,635 596,085   78,550
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 66,877 0   0
19 Depreciation (attach schedule) and depletion... 3,142 0  
20 Occupancy.............. 32,525 0   0
21 Travel, conferences, and meetings....... 21,929 0   21,929
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment 64,622 50,472   28,112
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 1,234,176 670,687   461,419
25 Contributions, gifts, grants paid....... 4,598,812 5,159,651
26 Total expenses and disbursements. Add lines 24 and 25 5,832,988 670,687   5,621,070
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 398,236
b Net investment income (if negative, enter -0-) 5,839,784
c Adjusted net income (if negative, enter -0-)...  
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2019)
Form 990-PF (2019)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.) 		Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing.............      
2 Savings and temporary cash investments......... 84,797 66,997 66,997
3 Accounts receivable bullet70,477
Less: allowance for doubtful accounts bullet   60,475 70,477 70,477
4 Pledges receivable bullet142,521
Less: allowance for doubtful accounts bullet   228,858 142,521 142,521
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions).....      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet        
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges.......... 43,656 57,558 57,558
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule)....... 51,290,946 Click to see attachment45,492,289 45,492,289
c Investments—corporate bonds (attach schedule)....... 42,002,461 Click to see attachment41,951,154 41,951,154
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule).......... 17,968,993 Click to see attachment19,887,722 19,887,722
14 Land, buildings, and equipment: basis bullet47,098
Less: accumulated depreciation (attach schedule) bullet40,713 6,077 Click to see attachment6,385 6,385
15 Other assets (describe bullet)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 111,686,263 107,675,103 107,675,103
Liabilities 17 Accounts payable and accrued expenses.......... 192,253 209,270
18 Grants payable................. 1,451,944 891,105
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet) Click to see attachment186,590 Click to see attachment151,526
23 Total liabilities (add lines 17 through 22)......... 1,830,787 1,251,901
Net Assets or Fund Balances Foundations that follow FASB ASC 958, check here bullet
and complete lines 24, 25, 29 and 30.
24 Net assets without donor restrictions...........    
25 Net assets with donor restrictions............    
Foundations that do not follow FASB ASC 958, check here bullet
and complete lines 26 through 30.
26 Capital stock, trust principal, or current funds........    
27 Paid-in or capital surplus, or land, bldg., and equipment fund    
28 Retained earnings, accumulated income, endowment, or other funds    
29 Total net assets or fund balances (see instructions)..... 109,855,476 106,423,202
30 Total liabilities and net assets/fund balances (see instructions). 111,686,263 107,675,103
Part III
Analysis of Changes in Net Assets or Fund Balances
1
Total net assets or fund balances at beginning of year—Part II, column (a), line 29 (must agree with end-of-year figure reported on prior year’s return) ...............
1
109,855,476
2
Enter amount from Part I, line 27a .....................
2
398,236
3
Other increases not included in line 2 (itemize) bullet
3
0
4
Add lines 1, 2, and 3 ..........................
4
110,253,712
5
Decreases not included in line 2 (itemize) bulletClick to see attachment
5
3,830,510
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
106,423,202
Form 990-PF (2019)
Form 990-PF (2019)
Page 3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)		 (b)
How acquired
P—Purchase
D—Donation 		(c)
Date acquired
(mo., day, yr.) 		(d)
Date sold
(mo., day, yr.)
1 a SEI CORE PROPERTY FUND, LLC P    
b 8.82 UNITS OF GOVERNMENT FUND (SEOXX)      
c 56,609.73 UNITS OF GOVERNMENT FUND (SEOXX)      
d 39.722 UNITS OF SEI LARGE CAP INDEX FUND (LCIAX)      
e 655.717 UNITS OF SEI CORE FIXED INCOME FUND (SCOAX)      
300.586 UNITS OF SEI WORLD EQUITY EX-US FUND (WEUSX)      
295.327 UNITS OF SEI GLOBAL MGD VOLATILITY FD (SGMAX)      
252.104 UNITS OF EMERGING MRKTS DEBT FUND (SEDAX)      
313.081 UNITS OF SEI OPPORTUNISTIC INC FD-A (ENIAX)      
131.134 UNITS OF SEI DYNAMIC ASSET ALLOC FUND (SDLAX)      
109.499 UNITS OF SEI SMALL CAP FUND (SLPAX)      
134.964 UNITS OF U.S. MANAGED VOL FUND (SVYAX)      
257.296 UNITS OF SEI MULTI ASSET REAL RETURN (SEIAX)      
170.251 UNITS OF HIGH YIELD BOND FUND (SGYAX)      
134.975 UNITS OF SEI EMERGING MRKTS EQ-A (SMQFX)      
56,083.82 UNITS OF GOVERNMENT FUND (SEOXX)      
143,844.78 UNITS OF GOVERNMENT FUND (SEOXX)      
14,398.878 UNITS OF SEI ULTRA SH DURATION BD FD (SUSAX)      
20,020.02 UNITS OF SEI ULTRA SH DURATION BD FD (SUSAX)      
43,029.37 UNITS OF SEI ULTRA SH DURATION BD FD (SUSAX)      
1,210,689.31 UNITS OF GOVERNMENT FUND (SEOXX)      
1,210,689.31 UNITS OF GOVERNMENT FUND (SEOXX)      
14,114.115 UNITS OF SEI ULTRA SH DURATION BD FD (SUSAX)      
391,860.37 UNITS OF GOVERNMENT FUND (SEOXX)      
391,860.37 UNITS OF GOVERNMENT FUND (SEOXX)      
88.81 UNITS OF GOVERNMENT FUND (SEOXX)      
850,695.16 UNITS OF GOVERNMENT FUND (SEOXX)      
40,425.33 UNITS OF GOVERNMENT FUND (SEOXX)      
53,793.37 UNITS OF GOVERNMENT FUND (SEOXX)      
2,104.208 UNITS OF SEI ULTRA SH DURATION BD FD (SUSAX)      
230,979.48 UNITS OF GOVERNMENT FUND (SEOXX)      
1.15 UNITS OF GOVERNMENT FUND (SEOXX)      
52,628.4 UNITS OF GOVERNMENT FUND (SEOXX)      
145,583.91 UNITS OF GOVERNMENT FUND (SEOXX)      
14,602.198 UNITS OF SEI ULTRA SH DURATION BD FD (SUSAX)      
101,959.911 UNITS OF SEI ULTRA SH DURATION BD FD (SUSAX)      
48,147.77 UNITS OF GOVERNMENT FUND (SEOXX)      
54.313 UNITS OFSEI LARGE CAP INDEX FUND (LCIAX)      
948.774 UNITS OF SEI CORE FIXED INCOME FUND (SCOAX)      
416.664 UNITS OF SEI WORLD EQUITY EX-US FUND (WEUSX)      
424.811 UNITS OF SEI GLOBAL MGD VOLATILITY FD (SGMAX)      
351.462 UNITS OF EMERGING MRKTS DEBT FUND (SEDAX)      
443.147 UNITS OF SEI OPPORTUNISTIC INC FD-A (ENIAX)      
185.129 UNITS OF SEI DYNAMIC ASSET ALLOC FUND (SDLAX)      
164.061 UNITS OF SEI SMALL CAP FUND (SLPAX)      
203.49 UNITS OFU.S. MANAGED VOL FUND (SVYAX)      
368.777 UNITS OF SEI MULTI ASSET REAL RETURN (SEIAX)      
243.892 UNITS OF HIGH YIELD BOND FUND (SGYAX)      
182.507 UNITS OF SEI EMERGING MRKTS EQ-A (SMQFX)      
20,060.181 UNITS OFSEI ULTRA SH DURATION BD FD (SUSAX)      
135.992 UNITS OF SEI LARGE CAP INDEX FUND (LCIAX)      
2,319.763 UNITS OF SEI CORE FIXED INCOME FUND (SCOAX)      
1,026.809 UNITS OF SEI WORLD EQUITY EX-US FUND (WEUSX)      
1,056.212 UNITS OF SEI GLOBAL MGD VOLATILITY FD (SGMAX)      
861.803 UNITS OF EMERGING MRKTS DEBT FUND (SEDAX)      
1,082.193 UNITS OF SEI OPPORTUNISTIC INC FD-A (ENIAX)      
464.598 UNITS OF SEI DYNAMIC ASSET ALLOC FUND (SDLAX)      
404.735 UNITS OF SEI SMALL CAP FUND (SLPAX)      
505.919 UNITS OF U.S. MANAGED VOL FUND (SVYAX)      
906.2 UNITS OF SEI MULTI ASSET REAL RETURN (SEIAX)      
601.051 UNITS OF HIGH YIELD BOND FUND (SGYAX)      
445.857 UNITS OF SEI EMERGING MRKTS EQ-A (SMQFX)      
52,847.67 UNITS OF GOVERNMENT FUND (SEOXX)      
291,195.25 UNITS OFGOVERNMENT FUND (SEOXX)      
101.119 UNITS OF SEI LARGE CAP INDEX FUND (LCIAX)      
1,722.054 UNITS OF SEI CORE FIXED INCOME FUND (SCOAX)      
757.576 UNITS OF SEI WORLD EQUITY EX-US FUND (WEUSX)      
767.946 UNITS OF SEI GLOBAL MGD VOLATILITY FD (SGMAX)      
657.371 UNITS OF EMERGING MRKTS DEBT FUND (SEDAX)      
803.898 UNITS OF SEI OPPORTUNISTIC INC FD-A (ENIAX)      
338.115 UNITS OF SEI DYNAMIC ASSET ALLOC FUND (SDLAX)      
298.255 UNITS OF SEI SMALL CAP FUND (SLPAX)      
371.669 UNITS OF U.S. MANAGED VOL FUND (SVYAX)      
660.025 UNITS OF SEI MULTI ASSET REAL RETURN (SEIAX)      
441.176 UNITS OF HIGH YIELD BOND FUND (SGYAX)      
339.13 UNITS OF SEI EMERGING MRKTS EQ-A (SMQFX)      
53,414.96 UNITS OF GOVERNMENT FUND (SEOXX)      
147,445.55 UNITS OF GOVERNMENT FUND (SEOXX)      
14,803.771 UNITS OF SEI ULTRA SH DURATION BD FD (SUSAX)      
252,783.529 UNITS OF SEI SMALL CAP FUND (SLPAX)      
34,085.711 UNITS OFSEI WORLD EQUITY EX-US FUND (WEUSX)      
9,703.298 UNITS OF SEI DYNAMIC ASSET ALLOC FUND (SDLAX)      
16,392.712 UNITS OFSEI EMERGING MRKTS EQ-A (SMQFX)      
1,705.007 UNITS OF SEI GLOBAL MGD VOLATILITY FD (SGMAX)      
210,695.06 UNITS OF GOVERNMENT FUND (SEOXX)      
56,338.2 UNITS OF GOVERNMENT FUND (SEOXX)      
60,190.302 UNITS OF SEI ULTRA SH DURATION BD FD (SUSAX)      
70,004.548 UNITS OF SEI ULTRA SH DURATION BD FD (SUSAX)      
15,865.964 UNITS OF SEI ULTRA SH DURATION BD FD (SUSAX)      
27 UNITS OF GOVERNMENT FUND (SEOXX)      
55,406.79 UNITS OF GOVERNMENT FUND (SEOXX)      
122,500 UNITS OF GOVERNMENT FUND (SEOXX)      
147,029.47 UNITS OFGOVERNMENT FUND (SEOXX)      
27,290.16 UNITS OF SEI ULTRA SH DURATION BD FD (SUSAX)      
58,173.47 UNITS OF GOVERNMENT FUND (SEOXX)      
20,060.18 UNITS OF SEI ULTRA SH DURATION BD FD (SUSAX)      
60,558.476 UNITS OF SEI ULTRA SH DURATION BD FD (SUSAX)      
148,296.24 UNITS OF GOVERNMENT FUND (SEOXX)      
14,874.246 UNITS OF SEI ULTRA SH DURATION BD FD (SUSAX)      
3,099.92 UNITS OF SEI ULTRA SH DURATION BD FD (SUSAX)      
3,938.404 UNITS OF SEI LARGE CAP INDEX FUND (LCIAX)      
68,537.074 UNITS OF SEI CORE FIXED INCOME FUND (SCOAX)      
31,343.284 UNITS OF SEI WORLD EQUITY EX-US FUND (WEUSX)      
29,183.188 UNITS OF SEI GLOBAL MGD VOLATILITY FD (SGMAX)      
29,763.247 UNITS OF EMERGING MRKTS DEBT FUND (SEDAX)      
32,077.764 UNITS OF SEI OPPORTUNISTIC INC FD-A (ENIAX)      
12,680.115 UNITS OF SEI DYNAMIC ASSET ALLOC FUND (SDLAX)      
13,847.159 UNITS OFU.S. MANAGED VOL FUND (SVYAX)      
26,302.729 UNITS OF SEI MULTI ASSET REAL RETURN (SEIAX)      
17,567.567 UNITS OF HIGH YIELD BOND FUND (SGYAX)      
15,189.874 UNITS OF SEI EMERGING MRKTS EQ-A (SMQFX)      
9,181.872 UNITS OF SEI EXTENDED MKT INDEX-A (SMXAX)      
62,588.94 UNITS OF GOVERNMENT FUND (SEOXX)      
57,110.2 UNITS OF GOVERNMENT FUND (SEOXX)      
71,603.274 UNITS OF SEI ULTRA SH DURATION BD FD (SUSAX)      
197,693.04 UNITS OF GOVERNMENT FUND (SEOXX)      
12,751.003 UNITS OF SEI ULTRA SH DURATION BD FD (SUSAX)      
19,079.217 UNITS OF SEI ULTRA SH DURATION BD FD (SUSAX)      
103.839 UNITS OF SEI LARGE CAP INDEX FUND (LCIAX)      
1,744.898 UNITS OF SEI CORE FIXED INCOME FUND (SCOAX)      
829.384 UNITS OF SEI WORLD EQUITY EX-US FUND (WEUSX)      
747.36 UNITS OF SEI GLOBAL MGD VOLATILITY FD (SGMAX)      
722.101 UNITS OF EMERGING MRKTS DEBT FUND (SEDAX)      
806.846 UNITS OF SEI OPPORTUNISTIC INC FD-A (ENIAX)      
328.195 UNITS OF SEI DYNAMIC ASSET ALLOC FUND (SDLAX)      
354.515 UNITS OF U.S. MANAGED VOL FUND (SVYAX)      
650.307 UNITS OF SEI MULTI ASSET REAL RETURN (SEIAX)      
443.182 UNITS OF SEI HIGH YIELD BOND FUND (SGYAX)      
406.674 UNITS OF SEI EMERGING MRKTS EQ-A (SMQFX)      
255.236 UNITS OF SEI EXTENDED MKT INDEX-A (SMXAX)      
1,004.017 UNITS OF SEI ULTRA SH DURATION BD FD (SUSAX)      
(e)
Gross sales price 		(f)
Depreciation allowed
(or allowable) 		(g)
Cost or other basis
plus expense of sale 		(h)
Gain or (loss)
(e) plus (f) minus (g)
a       0
b 9   9 0
c 56,610   56,610 0
d 7,768   7,113 655
e 6,741   6,758 -17
4,139   3,431 708
3,627   2,575 1,052
2,602   2,703 -101
2,602   2,565 37
2,602   2,223 379
2,089   1,418 671
2,089   1,631 458
2,089   2,313 -224
1,537   1,537 0
1,537   1,175 362
56,084   56,084 0
143,845   143,845 0
143,845   143,832 13
200,000   199,982 18
429,863   429,824 39
1,210,689   1,210,689 0
1,210,689   1,210,689 0
141,000   140,992 8
391,860   391,860 0
391,860   391,860 0
89   89 0
850,695   850,695 0
40,425   40,425 0
53,793   53,793 0
21,000   21,020 -20
230,979   230,979 0
1   1 0
52,629   52,629 0
145,584   145,584 0
145,584   145,860 -276
1,016,540   1,018,465 -1,925
48,148   48,148 0
10,952   9,726 1,226
9,507   9,778 -271
5,837   4,756 1,081
5,115   3,703 1,412
3,669   3,769 -100
3,669   3,630 39
3,669   3,138 531
2,947   2,125 822
2,947   2,460 487
2,947   3,315 -368
2,168   2,203 -35
2,168   1,588 580
200,000   200,372 -372
26,778   24,353 2,425
23,244   23,908 -664
14,273   11,719 2,554
12,506   9,208 3,298
8,971   9,242 -271
8,971   8,865 106
8,971   7,874 1,097
7,204   5,243 1,961
7,204   6,115 1,089
7,204   8,145 -941
5,301   5,428 -127
5,301   3,880 1,421
52,848   52,848 0
291,195   291,195 0
19,700   18,108 1,592
17,100   17,748 -648
10,500   8,647 1,853
9,200   6,695 2,505
6,600   7,049 -449
6,600   6,585 15
6,600   5,731 869
5,300   3,864 1,436
5,300   4,492 808
5,300   5,932 -632
3,900   3,984 -84
3,900   2,951 949
53,415   53,415 0
147,446   147,446 0
147,446   147,819 -373
4,742,219   3,274,623 1,467,596
469,701   389,035 80,666
192,417   164,462 27,955
183,762   142,667 41,095
20,545   14,863 5,682
210,695   210,695 0
56,338   56,338 0
599,495   600,987 -1,492
697,245   698,980 -1,735
158,025   158,417 -392
27   27 0
55,407   55,407 0
122,500   122,500 0
147,030   147,030 0
271,810   272,421 -611
58,174   58,174 0
200,000   200,235 -235
603,768   604,476 -708
148,296   148,296 0
148,296   148,470 -174
30,906   30,942 -36
844,000   706,004 137,996
684,000   705,396 -21,396
420,000   357,734 62,266
368,000   254,405 113,595
264,000   316,738 -52,738
264,000   262,817 1,183
264,000   214,916 49,084
212,000   169,062 42,938
212,000   235,962 -23,962
156,000   158,449 -2,449
156,000   132,198 23,802
156,000   146,431 9,569
62,589   62,589 0
57,110   57,110 0
713,169   714,037 -868
197,693   197,693 0
127,000   127,148 -148
190,029   190,250 -221
21,100   18,614 2,486
17,100   17,959 -859
10,500   9,466 1,034
9,200   6,515 2,685
6,600   7,685 -1,085
6,600   6,611 -11
6,600   5,563 1,037
5,300   4,328 972
5,300   5,834 -534
3,900   3,997 -97
3,900   3,539 361
3,900   4,070 -170
10,000   10,012 -12
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69 		(j)
Adjusted basis
as of 12/31/69 		(k)
Excess of col. (i)
over col. (j), if any
a       0
b       0
c       0
d       655
e       -17
      708
      1,052
      -101
      37
      379
      671
      458
      -224
      0
      362
      0
      0
      13
      18
      39
      0
      0
      8
      0
      0
      0
      0
      0
      0
      -20
      0
      0
      0
      0
      -276
      -1,925
      0
      1,226
      -271
      1,081
      1,412
      -100
      39
      531
      822
      487
      -368
      -35
      580
      -372
      2,425
      -664
      2,554
      3,298
      -271
      106
      1,097
      1,961
      1,089
      -941
      -127
      1,421
      0
      0
      1,592
      -648
      1,853
      2,505
      -449
      15
      869
      1,436
      808
      -632
      -84
      949
      0
      0
      -373
      1,467,596
      80,666
      27,955
      41,095
      5,682
      0
      0
      -1,492
      -1,735
      -392
      0
      0
      0
      0
      -611
      0
      -235
      -708
      0
      -174
      -36
      137,996
      -21,396
      62,266
      113,595
      -52,738
      1,183
      49,084
      42,938
      -23,962
      -2,449
      23,802
      9,569
      0
      0
      -868
      0
      -148
      -221
      2,486
      -859
      1,034
      2,685
      -1,085
      -11
      1,037
      972
      -534
      -97
      361
      -170
      -12
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7		 Bracket 2 1,988,727
3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8 ................... 		Bracket 3  
Part V
Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income
(For optional use by domestic private foundations subject to the section 4940(a) tax on net investment income.)

If section 4940(d)(2) applies, leave this part blank.
Was the foundation liable for the section 4942 tax on the distributable amount of any year in the base period?
If "Yes," the foundation does not qualify under section 4940(e). Do not complete this part.
1 Enter the appropriate amount in each column for each year; see instructions before making any entries.
(a)
Base period years Calendar
year (or tax year beginning in) 		(b)
Adjusted qualifying distributions 		(c)
Net value of noncharitable-use assets 		(d)
Distribution ratio
(col. (b) divided by col. (c))
2018 4,850,615 106,530,115 0.045533
2017 5,247,271 98,321,142 0.053369
2016 4,980,260 100,254,131 0.049676
2015 4,672,707 100,774,355 0.046368
2014 4,370,054 95,756,146 0.045637
2
Total of line 1, column (d) .....................
2
0.240583
3
Average distribution ratio for the 5-year base period—divide the total on line 2 by 5.0, or by the number of years the foundation has been in existence if less than 5 years ......
3
0.048117
4
Enter the net value of noncharitable-use assets for 2019 from Part X, line 5......
4
110,334,651
5
Multiply line 4 by line 3......................
5
5,308,972
6
Enter 1% of net investment income (1% of Part I, line 27b)...........
6
58,398
7
Add lines 5 and 6........................
7
5,367,370
8
Enter qualifying distributions from Part XII, line 4,.............
8
5,621,070
If line 8 is equal to or greater than line 7, check the box in Part VI, line 1b, and complete that part using a 1% tax rate. See the Part VI instructions.
Form 990-PF (2019)
Form 990-PF (2019)
Page 4
Part VI
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a Exempt operating foundations described in section 4940(d)(2), check here Bullet and enter “N/A" on line 1. Bracket includes lines 1a and 1b
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b Domestic foundations that meet the section 4940(e) requirements in Part V, check 1 58,398
hereBulletand enter 1% of Part I, line 27b...................
c All other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2 0
3 Add lines 1 and 2........................... 3 58,398
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4 0
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 58,398
6 Credits/Payments:
a 2019 estimated tax payments and 2018 overpayment credited to 2019 6a 68,459
b Exempt foreign organizations—tax withheld at source...... 6b
c Tax paid with application for extension of time to file (Form 8868)... 6c 0
d Backup withholding erroneously withheld ........... 6d 0
7 Total credits and payments. Add lines 6a through 6d.............. 7 68,459
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. 8 0
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10 10,061
11 Enter the amount of line 10 to be: Credited to 2020 estimated taxBullet10,061 RefundedBullet 11 0
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? (see Instructions
for definition).................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$ 0(2) On foundation managers.bullet$ 0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$ 0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
    • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletVA
    b
    If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If "No," attach explanation .
    8b
    Yes
     
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 2019 or the taxable year beginning in 2019? See the instructions for Part XIV.
    If "Yes," complete Part XIV .............................
    9
     
    No
    10
    Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names
    and addresses. ...............................
    10
     
    No
    Form 990-PF (2019)
    Form 990-PF (2019)
    Page 5
    Part VII-A
    Statements Regarding Activities (continued)
    11
    At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
    meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions .............
    11
     
    No
    12
    Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
    advisory privileges? If "Yes," attach statement. See instructions.................
    12
     
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
    Yes
     
    Website addressbulletWWW.POTOMACHEALTHFOUNDATION.ORG
    14
    The books are in care ofbulletSUSIE LEE Telephone no.bullet (703) 523-0620

    Located atbullet2296 OPITZ BOULEVARD SUITE 200WOODBRIDGEVA ZIP+4bullet22191
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ........bullet
    15
     
    16 At any time during calendar year 2019, did the foundation have an interest in or a signature or other authority over YesNo
    a bank, securities, or other financial account in a foreign country? .................
    16   No
    See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
    country bullet
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person?
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person?......................
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person?
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)?...............
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.).......
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ........
    1b
     
    No
    ........bullet
    c
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2019?.............
    1c
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2019, did the foundation have any undistributed income (lines 6d
    and 6e, Part XIII) for tax year(s) beginning before 2019?.............
    If "Yes," list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer "No" and attach statement—see instructions.) ..............
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year?......................
    b
    If "Yes," did it have excess business holdings in 2019 as a result of (1) any purchase by the foundation
    or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
    by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
    the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2019.)..................
    3b
     
     
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2019?
    4b
     
    No
    Form 990-PF (2019)
    Form 990-PF (2019)
    Page 6
    Part VII-B
    Statements Regarding Activities for Which Form 4720 May Be Required (continued)
    5a
    During the year did the foundation pay or incur any amount to:
    Yes
    No
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive?.............
    (3) Provide a grant to an individual for travel, study, or other similar purposes?
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? See instructions................
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals?.....
    b
    If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions ......
    5b
     
     
    .........bullet
    c
    If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant?..........
    If "Yes," attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
    a personal benefit contract?.....................
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....
    6b
     
    No
    If "Yes" to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    b
    If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction? ....
    7b
     
     
    8
    Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
    excess parachute payment during the year? .................
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors
    1 List all officers, directors, trustees, foundation managers and their compensation. See instructions
    (a) Name and address (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation
     (If not paid, enter
    -0-)     		(d) Contributions to employee benefit plans and deferred compensation (e) Expense account,
    other allowances
    MARION M WALL CHAIR
    4.00     		0 0 0
    2296 OPITZ BOULEVARD SUITE 200
    WOODBRIDGE,VA22191
    CAROL S SHAPIRO MD VICE-CHAIR
    4.00     		0 0 0
    2296 OPITZ BOULEVARD SUITE 200
    WOODBRIDGE,VA22191
    R MICHAEL SORENSEN TREASURER
    3.00     		0 0 0
    2296 OPITZ BOULEVARD SUITE 200
    WOODBRIDGE,VA22191
    WAYNE MALLARD SECRETARY
    2.00     		0 0 0
    2296 OPITZ BOULEVARD SUITE 200
    WOODBRIDGE,VA22191
    HOWARD L GREENHOUSE DIRECTOR
    1.00     		0 0 0
    2296 OPITZ BOULEVARD SUITE 200
    WOODBRIDGE,VA22191
    SARAH PITKIN PHD DIRECTOR
    1.00     		0 0 0
    2296 OPITZ BOULEVARD SUITE 200
    WOODBRIDGE,VA22191
    WILLIAM M MOSS DIRECTOR
    1.00     		0 0 0
    2296 OPITZ BOULEVARD SUITE 200
    WOODBRIDGE,VA22191
    CARLOS CASTRO DIRECTOR
    1.00     		0 0 0
    2296 OPITZ BOULEVARD SUITE 200
    WOODBRIDGE,VA22191
    SAM HILL EDD DIRECTOR
    1.00     		0 0 0
    2296 OPITZ BOULEVARD SUITE 200
    WOODBRIDGE,VA22191
    MEGAN PERRY DIRECTOR
    1.00     		0 0 0
    2296 OPITZ BOULEVARD SUITE 200
    WOODBRIDGE,VA22191
    SUSIE LEE EXECUTIVE DIRECTOR
    40.00     		132,945 27,918 788
    2296 OPITZ BOULEVARD SUITE 200
    WOODBRIDGE,VA22191
    2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation     		(e) Expense account,
    other allowances
    TIMOTHY MCCUE DIRECTOR OF GRANTS P
    40.00     		113,115 23,754 1,029
    2296 OPITZ BLVD SUITE 200
    WOODBRIDGE,VA22191
    Total number of other employees paid over $50,000...................bullet 0
    Form 990-PF (2019)
    Form 990-PF (2019)
    Page 7
    Part VIII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors (continued)
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
    SEI GLOBAL INSTITUTIONAL GROUP INVESTMENT MANAGEMENT 596,085
    1 FREEDOM VALLEY DRIVE
    OAKS,PA19456
    COMMUNITY HEALTH SOLUTIONS INC CONSULTING SERVICES FOR MANAGING THE MENTAL HEALTH GRANTEE COHORT COLLABORAT 54,000
    9603 GAYTON ROAD SUITE 201
    HENRICO,VA23238
    Total number of others receiving over $50,000 for professional services.............bullet0
    Part IX-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1  
    2  
    3  
    4  
    Part IX-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet0
    Form 990-PF (2019)
    Form 990-PF (2019)
    Page 8
    Part X
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    111,878,118
    b
    Average of monthly cash balances.......................
    1b
    136,756
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    112,014,874
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
    0
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
    0
    3
    Subtract line 2 from line 1d.........................
    3
    112,014,874
    4
    Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
    instructions) .............................
    4
    1,680,223
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4
    5
    110,334,651
    6
    Minimum investment return. Enter 5% of line 5..................
    6
    5,516,733
    Part XI
    Distributable Amount (see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here right arrow and do not complete this part.)
    1
    Minimum investment return from Part X, line 6....................
    1
    5,516,733
    2a
    Tax on investment income for 2019 from Part VI, line 5......
    2a
    58,398
    b
    Income tax for 2019. (This does not include the tax from Part VI.)...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    58,398
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    5,458,335
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    5,458,335
    6
    Deduction from distributable amount (see instructions).................
    6
    0
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1 ...
    7
    5,458,335
    Part XII
    Qualifying Distributions (see instructions)
    1
    Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:
    a
    Expenses, contributions, gifts, etc.—total from Part I, column (d), line 26 ..........
    1a
    5,621,070
    b
    Program-related investments—total from Part IX-B..................
    1b
    0
    2
    Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
    purposes...............................
    2
     
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
     
    b
    Cash distribution test (attach the required schedule) .................
    3b
     
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
    4
    5,621,070
    5
    Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment
    income. Enter 1% of Part I, line 27b. See instructions.................
    5
    58,398
    6
    Adjusted qualifying distributions. Subtract line 5 from line 4..............
    6
    5,562,672
    Note: The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whether the foundation qualifies for
    the section 4940(e) reduction of tax in those years.
    Form 990-PF (2019)
    Form 990-PF (2019)
    Page 9
    Part XIII
    Undistributed Income (see instructions)
    (a)
    Corpus     		(b)
    Years prior to 2018     		(c)
    2018     		(d)
    2019
    1 Distributable amount for 2019 from Part XI, line 7 5,458,335
    2 Undistributed income, if any, as of the end of 2019:
    a Enter amount for 2018 only....... 4,867,945
    b Total for prior years:20, 20, 20 0
    3 Excess distributions carryover, if any, to 2019:
    a From 2014......  
    b From 2015......  
    c From 2016......  
    d From 2017......  
    e From 2018......  
    fTotal of lines 3a through e........ 0
    4Qualifying distributions for 2019 from Part
    XII, line 4: bullet$ 5,621,070
    a Applied to 2018, but not more than line 2a 4,867,945
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		0
    c Treated as distributions out of corpus (Election
    required—see instructions)........     		0
    d Applied to 2019 distributable amount..... 753,125
    e Remaining amount distributed out of corpus 0
    5 Excess distributions carryover applied to 2019. 0 0
    (If an amount appears in column (d), the
    same amount must be shown in column (a).)
    6Enter the net total of each column as
    indicated below:
    a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 0
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ..........     		0
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......     		0
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........     		0
    e Undistributed income for 2018. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		0
    f Undistributed income for 2019. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2020 ..........     		4,705,210
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......     		0
    8 Excess distributions carryover from 2014 not
    applied on line 5 or line 7 (see instructions) ...     		0
    9Excess distributions carryover to 2020.
    Subtract lines 7 and 8 from line 6a ......     		0
    10 Analysis of line 9:
    a Excess from 2015....  
    b Excess from 2016....  
    c Excess from 2017....  
    d Excess from 2018....  
    e Excess from 2019....  
    Form 990-PF (2019)
    Form 990-PF (2019)
    Page 10
    Part XIV
    Private Operating Foundations (see instructions and Part VII-A, question 9)
    1a If the foundation has received a ruling or determination letter that it is a private operating
    foundation, and the ruling is effective for 2019, enter the date of the ruling....... bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    2a Enter the lesser of the adjusted net
    income from Part I or the minimum
    investment return from Part X for each
    year listed ..........     		Tax year Prior 3 years (e) Total
    (a) 2019 (b) 2018 (c) 2017 (d) 2016
             
    b 85% of line 2a .........          
    c Qualifying distributions from Part XII,
    line 4 for each year listed .....     		         
    d Amounts included in line 2c not used directly
    for active conduct of exempt activities ..........     		         
    e Qualifying distributions made directly
    for active conduct of exempt activities.
    Subtract line 2d from line 2c ....     		         
    3 Complete 3a, b, or c for the
    alternative test relied upon:
    a “Assets" alternative test—enter:
    (1) Value of all assets ......          
    (2) Value of assets qualifying
    under section 4942(j)(3)(B)(i)    		          
    b “Endowment" alternative test— enter 2/3
    of minimum investment return shown in
    Part X, line 6 for each year listed...     		         
    c “Support" alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....     		         
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....     		         
    (3) Largest amount of support
    from an exempt organization    		          
    (4) Gross investment income          
    Part XV
    Supplementary Information (Complete this part only if the foundation had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
    TIMOTHY MCCUE
    2296 OPITZ BOULEVARD SUITE 200
    WOODBRIDGE,VA22191
    (703) 523-0630
    TIMOTHY@POTOMACHEALTHFOUNDATION.ORG
    bThe form in which applications should be submitted and information and materials they should include:
    LETTER OF INTENT TO INCLUDE NARRATIVE AND BUDGET PLAN, COMPLETED AND SUBMITTED ONLINE.
    cAny submission deadlines:
    JANUARY 25, 2019
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    THE FOUNDATION AWARDS GRANTS TO TAX-EXEMPT ORGANIZATIONS THAT SERVE INDIVIDUALS IN EASTERN PRINCE WILLIAM COUNTY, LORTON, NORTH STAFFORD IN VIRGINIA. PROJECTS MUST WORK TOWARD IMPROVING THE HEALTH OF THE COMMUNITY. PROJECTS ARE FUNDED FOR A 12 MONTH PERIOD. THE FOUNDATION DOES NOT FUND SPONSORSHIPS, INCLUDING FUNDRAISING EVENTS, ENDOWMENTS, LOBBYING, DIRECT SUPPORT TO INDIVIDUALS, PROGRAMS OF RELIGIOUS, FRATERNAL, ATHLETIC, OR VETERANS GROUPS WHEN THE PRIMARY BENEFICIARIES OF SUCH UNDERTAKINGS WOULD BE THEIR MEMBERS EXCLUSIVELY, GRANTS TO RETIRE ANY FORM OF DEBT, SCIENTIFIC RESEARCH GRANTS, AND INDIRECT COST PERCENTAGES.
    Form 990-PF (2019)
    Form 990-PF (2019)
    Page 11
    Part XV
    Supplementary Information (continued)
    3 Grants and Contributions Paid During the Year or Approved for Future Payment
    Recipient If recipient is an individual,
    show any relationship to
    any foundation manager
    or substantial contributor
    		 Foundation
    status of
    recipient     		Purpose of grant or
    contribution     		Amount
    Name and address (home or business)
    aPaid during the year
    ACTION IN COMMUNITY THROUGH SERVICE
    3900 ACTS LANE
    DUMFRIES,VA22026     		NONE PC COMPREHENSIVE CASE MANAGEMENT SYSTEM 12,400
    ACTION IN COMMUNITY THROUGH SERVICE
    3900 ACTS LANE
    DUMFRIES,VA22026     		NONE PC BEHAVIORAL HEALTH TREATMENT FOR HOMELESS CLIENTS 80,822
    ACTION IN COMMUNITY THROUGH SERVICE
    3900 ACTS LANE
    DUMFRIES,VA22026     		NONE PC INTEGRATED CASE MANAGEMENT SYSTEM PHASE TWO 26,200
    BRAIN INJURY SERVICES
    8136 OLD KEENE MILL ROAD
    SPRINGFIELD,VA22152     		NONE PC CREST: COLLABORATIVE REHABILITATION TO ENHANCE STROKE TREATMENT 73,624
    CATALOGUE FOR PHILANTHROPY GREATER WASHINGTON
    10 G STREET NE SUITE 600
    WASHINGTON DC,DC20002     		NONE PC LEARNING COMMONS 10,000
    CENTER FOR NONPROFIT ADVANCEMENT
    1666 K STREET NW SUITE 440
    WASHINGTON DC,DC20006     		NONE PC RECURRING IN-PERSON TRAININGS 25,000
    CHANGE IN ACTION INC
    128884 HARBOR DRIVE SUITE 203
    WOODBRIDGE,VA22192     		NONE PC BEHAVIORAL MANAGEMENT FOR TRAUMATIC EXPOSURE 50,460
    COALITION FOR HUMAN SERVICES
    PO BOX 3111
    MANASSAS,VA20110     		NONE PC RACISM SERIES 5,000
    CONSUMER HEALTH FOUNDATION
    1400 16TH STREET NW SUITE 710
    WASHINGTON,DC20036     		NONE PC REGIONAL PRIMARY CARE COALITION 9,200
    CONSUMER HEALTH FOUNDATION
    1400 16TH STREET NW SUITE 710
    WASHINGTON,DC20036     		NONE PC REGIONAL PRIMARY CARE COALITION 16,594
    COURT APPOINTED SPECIAL ADVOCATES
    9384 FORESTWOOD LANE SUITE C
    MANASSAS,VA20110     		NONE PC FACILITY RENOVATION 50,000
    EMPOWERHOUSE
    PO BOX 1007
    FREDRICKSBURG,VA22402     		NONE PC INTERPERSONAL VIOLENCE HEALTHCARE PARTNERSHIP PROGRAM 25,255
    GEORGE MASON UNIVERSITY
    10900 UNIVERSITY BOULEVARD MS 4E5
    MANASSAS,VA20110     		NONE PC A FAMILY-BASED EMPOWERMENT PROGRAM TO TARGET EARLY TREATMENT FOR CHILDHOOD OBESITY IN LOW INCOME LATINO COMMUNITIES 46,987
    GEORGE MASON UNIVERSITY
    10900 UNIVERSITY BOULEVARD MS 4E5
    MANASSAS,VA20110     		NONE PC MIDDLE SCHOOL ACHIEVES (ADVANCING HEALTHCARE INITIATIVES FOR UNDERSERVED STUDENTS) 99,899
    GEORGE MASON UNIVERSITY
    10900 UNIVERSITY BOULEVARD MS 4E5
    MANASSAS,VA20110     		NONE PC POISED (PRECISION OUTREACH INTERVENTION, SCREENING, SURVEILLANCE AND EXERCISE FOR FALLS PREVENTION IN DIABETES) PRINCE WILLIAM 84,164
    GEORGE MASON UNIVERSITY
    10900 UNIVERSITY BOULEVARD MS 4E5
    MANASSAS,VA20110     		NONE PC A FAMILY-BASED EMPOWERMENT PROGRAM TO TARGET EARLY TREATMENT FOR CHILDHOOD OBESITY IN LOW INCOME LATINO COMMUNITIES 89,023
    GEORGE MASON UNIVERSITY
    10900 UNIVERSITY BOULEVARD MS 4E5
    MANASSAS,VA20110     		NONE PC HARM REDUCTION APPROACH TO THE COMMUNITY OPIOID CRISIS 66,547
    GEORGE WASHINGTON REGIONAL COMMISSION
    406 PRINCESS ANNE STREET
    FREDRICKSBURG,VA22402     		NONE PC FRESH FOOD ACCESS FOR COMMUNITY HEALTH 19,094
    GREATER PRINCE WILLIAM COMMUNITY HEALTH CENTER
    4379 RIDGEWOOD CENTER DRIVE SUITE
    102
    WOODBRIDGE,VA22192     		NONE PC GENERAL OPERATING SUPPORT 135,000
    GREATER PRINCE WILLIAM COMMUNITY HEALTH CENTER
    4379 RIDGEWOOD CENTER DRIVE SUITE
    102
    WOODBRIDGE,VA22192     		NONE PC BRIDGING THE BEHAVIORAL HEALTH GAP - GPWCHC/GMU PRECEPTORSHIP PIPELINE 105,000
    GREATER PRINCE WILLIAM COMMUNITY HEALTH CENTER
    4379 RIDGEWOOD CENTER DRIVE SUITE
    102
    WOODBRIDGE,VA22192     		NONE PC MAKE A CHANGE (MAC) GANG TATTOO REMOVAL PROGRAM 22,400
    GREATER PRINCE WILLIAM COMMUNITY HEALTH CENTER
    4379 RIDGEWOOD CENTER DRIVE SUITE
    102
    WOODBRIDGE,VA22192     		NONE PC LATINO MENTAL HEALTH AWARENESS AND OUTREACH 25,000
    INOVA HEALTH CARE SERVICES
    2740 PROSPERITY AVENUE SUITE 200
    FAIRFAX,VA22031     		NONE PC EXPANDING BEHAVIORAL HEALTH SERVICE CAPACITY IN PRINCE WILLIAM COUNTY 116,343
    LEADERSHIP PRINCE WILLIAM
    9720 CAPITAL COURT SUITE 204
    MANASSAS,VA20110     		NONE PC SCHOLARSHIP FUND 16,500
    LLOYD F MOSS FREE CLINIC
    1301 SAM PERRY BOULEVARD
    FREDERICKSBURG,VA22401     		NONE PC GENERAL OPERATING SUPPORT 139,500
    LLOYD F MOSS FREE CLINIC
    1301 SAM PERRY BOULEVARD
    FREDERICKSBURG,VA22401     		NONE PC MEDICAID EXPANSION READINESS PROJECT 9,500
    NATIONAL CAPITAL POISON CENTER
    3201 NEW MEXICO AVENUE SUITE 310
    WASHINGTON,DC20016     		NONE PC WEBPOISONCONTROL: ENHANCEMENT OF AN ON-LINE PROTOTYPE TRIAGE APPLICATION TO INCREASE ACCESS TO POISON CONTROL SERVICES AND MINIMIZE INJURY FROM POISONINGS 78,402
    NATIONAL CAPITAL POISON CENTER
    3201 NEW MEXICO AVENUE SUITE 310
    WASHINGTON,DC20016     		NONE PC GENERAL OPERATING SUPPORT 54,000
    NATIONAL COALITION OF 100 BLACK WOMEN
    PO BOX 1166
    DUMFRIES,VA22026     		NONE PC DIABETES AWARENESS PROJECT 39,200
    NATIONAL COALITION OF 100 BLACK WOMEN
    PO BOX 1166
    DUMFRIES,VA22026     		NONE PC RESPONDING & PROTECTING (RAP) MIDDLE SCHOOL STUDENTS AND PARENTS 100,800
    NORTHERN VIRGINIA FAMILY SERVICE
    10455 WHITE GRANITE DRIVE SUITE 100
    OAKTON,VA22124     		NONE PC MENTAL HEALTH FOR FAMILIES WITH CHILDREN 26,352
    NORTHERN VIRGINIA FAMILY SERVICE
    10455 WHITE GRANITE DRIVE SUITE 100
    OAKTON,VA22124     		NONE PC IMPROVING NUTRITION FOR LOW-INCOME FAMILIES 64,512
    NORTHERN VIRGINIA FAMILY SERVICE
    10455 WHITE GRANITE DRIVE SUITE 100
    OAKTON,VA22124     		NONE PC GENERAL OPERATING SUPPORT 31,500
    NORTHERN VIRGINIA FAMILY SERVICE
    10455 WHITE GRANITE DRIVE SUITE 100
    OAKTON,VA22124     		NONE PC MENTAL HEALTH FOR FAMILIES WITH CHILDREN 87,100
    NOVA SCRIPTSCENTRAL INC
    6400 ARLINGTON BOULEVARD SUITE 120
    FALLS CHURCH,VA22042     		NONE PC GENERAL OPERATING SUPPORT 199,269
    NOVA SCRIPTSCENTRAL INC
    6400 ARLINGTON BOULEVARD SUITE 120
    FALLS CHURCH,VA22042     		NONE PC NSC EXPANSION PROJECT: CO-LOCATION AT GMU COMMUNITY RESOURCE CENTER 92,000
    NUEVA VIDA INC
    5225 WISCONSIN AVENUE NW SUITE 503
    WASHINGTON,DC20015     		NONE PC INCREASING CANCER PREVENTION AND IMPROVING CONTINUITY OF CARE TO UNDERSERVED LATINAS IN PWC 38,997
    NUEVA VIDA INC
    5225 WISCONSIN AVENUE NW SUITE 503
    WASHINGTON,DC20015     		NONE PC INCREASING CANCER PREVENTION AND IMPROVING CONTINUITY OF CARE TO UNDERSERVED LATINAS IN PWC 68,211
    PATHWAY HOMES
    10201 FAIRFAX BOULEVARD
    FAIRFAX,VA22030     		NONE PC MAP 5,000
    PATHWAY HOMES
    10201 FAIRFAX BOULEVARD
    FAIRFAX,VA22030     		NONE PC PERMANENT SUPPORTIVE HOUSING FOR INDIVIDUALS WITH SERIOUS MENTAL ILLNESSES 50,000
    PATHWAY HOMES
    10201 FAIRFAX BOULEVARD
    FAIRFAX,VA22030     		NONE PC PERMANENT SUPPORTIVE HOUSING FOR INDIVIDUALS WITH SERIOUS MENTAL ILLNESSES 105,000
    POSTPARTUM SUPPORT VIRGINIA
    PO BOX 7521
    ARLINGTON,VA22207     		NONE PC SUPPORT FOR WOMEN EXPERIENCING POSTPARTUM DEPRESSION 17,500
    POTOMAC AND RAPPAHANNOCK TRANSPORTATION COMMISSION
    14700 POTOMAC MILLS ROAD
    WOODBRIDGE,VA22192     		NONE PC MOBILITY ON DEMAND STUDY 20,000
    PRINCE WILLIAM AREA AGENCY ON AGING
    5 COUNTY COMPLEX COURT SUITE 240
    PRINCE WILLIAM,VA22192     		NONE PC NO WRONG DOOR EXPANDED CAPACITY 115,000
    PRINCE WILLIAM AREA FREE CLINIC
    13900 CHURCH HILL DRIVE
    WOODBRIDGE,VA22191     		NONE PC PWAFC NAVIGATION 19,786
    PRINCE WILLIAM AREA FREE CLINIC
    13900 CHURCH HILL DRIVE
    WOODBRIDGE,VA22191     		NONE PC IMPROVING PATIENT CARE WITH ELECTRONIC HEALTH RECORDS 16,000
    PRINCE WILLIAM AREA FREE CLINIC
    13900 CHURCH HILL DRIVE
    WOODBRIDGE,VA22191     		NONE PC GENERAL OPERATING SUPPORT 171,026
    PRINCE WILLIAM AREA FREE CLINIC
    13900 CHURCH HILL DRIVE
    WOODBRIDGE,VA22191     		NONE PC TRAINING AND DEVELOPMENT FOR THE PWAFC'S FUTURE 25,000
    PRINCE WILLIAM AREA FREE CLINIC
    13900 CHURCH HILL DRIVE
    WOODBRIDGE,VA22191     		NONE PC GENERAL OPERATING SUPPORT 190,029
    PRINCE WILLIAM CHAMBER OF COMMERCE
    9720 CAPITAL COURT SUITE 203
    MANASSAS,VA20110     		NONE PC PARTNERING WITH BUSINESS SERIES 5,000
    PRINCE WILLIAM DROP-IN CENTER
    13184 CENTERPOINTE WAY
    WOODBRIDGE,VA22192     		NONE PC OUTREACH & EDUCATION 30,800
    PROJECT MEND-A-HOUSE INC
    9500 TECHNOLOGY DRIVE SUITE 101
    MANASSAS,VA20110     		NONE PC PREVENTING HEALTH COMPLICATIONS THROUGH PARTICIPATION IN THE STANFORD CHRONIC DISEASE SELF-MANAGEMENT PROGRAM (CDSMP) AND THE DIABETES SELF-MANAGEMENT PROGRAM (DSMP) 16,000
    RX PARTNERSHIP
    2924 EMERYWOOD PARKWAY SUITE 300
    RICHMOND,VA23294     		NONE PC RXP ACCESS TO MEDICATION PROGRAM (AMP) 20,000
    RX PARTNERSHIP
    2924 EMERYWOOD PARKWAY SUITE 300
    RICHMOND,VA23294     		NONE PC GENERAL OPERATING SUPPORT 22,500
    SCAN OF NORTHERN VIRGINIA
    205 S WHITING STREET SUITE 205
    ALEXANDRIA,VA22304     		NONE PC SAFE BABIES AND CHILD ABUSE PREVENTION 10,000
    SCAN OF NORTHERN VIRGINIA
    205 S WHITING STREET SUITE 205
    ALEXANDRIA,VA22304     		NONE PC IMMIGRANT FAMILY REUNIFICATION: BUILDING RESILIENT YOUTH AND FAMILIES 73,725
    SEMPER K9 ASSISTANCE DOGS
    14867 PRESTIGE DRIVE
    WOODBRIDGE,VA22193     		NONE PC FAMILY INTEGRATION PROGRAM 7,500
    SENTARA NORTHERN VIRGINIA MEDICAL CENTER
    2300 OPITZ BOULEVARD
    WOODBRIDGE,VA22191     		NONE PC IN-PERSON INTERPRETER 80,520
    SENTARA NORTHERN VIRGINIA MEDICAL CENTER
    2300 OPITZ BOULEVARD
    WOODBRIDGE,VA22191     		NONE PC SNVMC DIABETES PREVENTION PROGRAM 24,512
    SENTARA NORTHERN VIRGINIA MEDICAL CENTER
    2300 OPITZ BOULEVARD
    WOODBRIDGE,VA22191     		NONE PC GENERAL OPERATING SUPPORT 135,000
    SENTARA NORTHERN VIRGINIA MEDICAL CENTER
    2300 OPITZ BOULEVARD
    WOODBRIDGE,VA22191     		NONE PC IN-PERSON INTERPRETER 140,910
    SENTARA NORTHERN VIRGINIA MEDICAL CENTER
    2300 OPITZ BOULEVARD
    WOODBRIDGE,VA22191     		NONE PC CANCER RESOURCE CENTER 125,000
    STAFFORD SCHOOLS HEAD START
    610 GAYLE STREET
    FALMOUTH,VA22405     		NONE PC SATAFFORD CHILDREN'S INSURANCE OUTREACH PROGRAM 5,797
    STAFFORD SCHOOLS HEAD START
    610 GAYLE STREET
    FALMOUTH,VA22405     		NONE PC STAFFORD CHILDREN'S HEALTH INSURANCE OUTREACH PROGRAM 10,144
    THE ARC OF GREATER PRINCE WILLIAMINSIGHT INC
    13505 HILLENDALE DRIVE
    DALE CITY,VA22193     		NONE PC COMPLETION OF THERAPEUTIC SERVICES 32,000
    THE ARC OF GREATER PRINCE WILLIAMINSIGHT INC
    13505 HILLENDALE DRIVE
    DALE CITY,VA22193     		NONE PC VOSAC III 26,532
    THE ARC OF GREATER PRINCE WILLIAMINSIGHT INC
    13505 HILLENDALE DRIVE
    DALE CITY,VA22193     		NONE PC COMPLETION OF THERAPEUTIC SERVICES 55,300
    THE ARC OF GREATER PRINCE WILLIAMINSIGHT INC
    13505 HILLENDALE DRIVE
    DALE CITY,VA22193     		NONE PC VOSAC III 67,725
    THE ARC OF GREATER PRINCE WILLIAMINSIGHT INC
    13505 HILLENDALE DRIVE
    DALE CITY,VA22193     		NONE PC INCREASE AGENCY CAPACITY TO BETTER SERVE PERSONS WHO ARE DUALLY DIAGNOSED (DD/MH) 35,000
    THE ARC OF GREATER PRINCE WILLIAMINSIGHT INC
    13505 HILLENDALE DRIVE
    DALE CITY,VA22193     		NONE PC IT CAPACITY BUILDING 195,300
    THE DOORWAYS
    612 E MARSHALL SREET
    RICHMOND,VA23219     		NONE PC PATIENT AND FAMILY ACCESS PROGRAM 15,200
    THE DOORWAYS
    612 E MARSHALL SREET
    RICHMOND,VA23219     		NONE PC PATIENT AND FAMILY ACCESS PROGRAM 26,600
    THE HOUSE INC
    14001 CROWN COURT
    WOODBRIDGE,VA22193     		NONE PC PROJECT PLAY 76,000
    THE HOUSE INC
    14001 CROWN COURT
    WOODBRIDGE,VA22193     		NONE PC THE OFFICE ON YOUTH MENTAL HEALTH AND WELLNESS 50,800
    THE HOUSE INC
    14001 CROWN COURT
    WOODBRIDGE,VA22193     		NONE PC THE OFFICE ON YOUTH MENTAL HEALTH AND WELLNESS 88,900
    VIRGINIA CENTER FOR HEALTH INNOVATION
    3831 WESTERRE PARKWAY SUITE C
    HENRICO,VA23233     		NONE PC POTOMAC PRIMARY CARE COLLABORATIVE 59,811
    VIRGINIA CENTER FOR HEALTH INNOVATION
    3831 WESTERRE PARKWAY SUITE C
    HENRICO,VA23233     		NONE PC HEALTHY MINDS, HEALTHY CHILDREN 127,716
    VIRGINIA COMMUNITY FOOD CONNECTIONS (GWRC)
    1287 CENTRAL PARK BOULEVARD
    FREDERICKSBURG,VA22401     		NONE PC FRESH FOOD ACCESS FOR COMMUNITY HEALTH 32,763
    VIRGINIA FOUNDATION FOR COMMUNITY COLLEGE EDUCATION
    101 N 14TH STREET
    RICHMOND,VA23219     		NONE PC POTOMAC HEALTH FOUNDATION FELLOWS PROGRAM 50,000
    VIRGINIA FOUNDATION FOR COMMUNITY COLLEGE EDUCATION
    101 N 14TH STREET
    RICHMOND,VA23219     		NONE PC POTOMAC HEALTH FOUNDATION FELLOWS PROGRAM 87,500
    VIRGINIA HEALTH CARE FOUNDATION
    707 E MAIN STREET
    RICHMOND,VA23219     		NONE PC SIGN UP NOW CLASSES 27,300
    VOICES FOR VIRGINIA'S CHILDREN
    701 E FRANKLIN STREET SUITE 807
    RICHMOND,VA23219     		NONE PC CAMPAIGN FOR CHILDREN'S MENTAL HEALTH 18,000
    VOICES FOR VIRGINIA'S CHILDREN
    701 E FRANKLIN STREET SUITE 807
    RICHMOND,VA23219     		NONE PC CAMPAIGN FOR CHILDREN'S MENTAL HEALTH 42,000
    WORKHOUSE ARTS FOUNDATION INC
    9518 WORKHOUSE WAY
    LORTON,VA22079     		NONE PC WORKHOUSE ARTS CENTER - MILITARY IN THE ARTS INITIATIVE 51,100
    YOUNG INVINCIBLES
    1411 K STREET NW
    WASHINGTON,DC20005     		NONE PC HEALTHY YOUNG AMERICA-NORTHERN VIRGINIA CAMPAIGN 40,000
    YOUNG INVINCIBLES
    1411 K STREET NW
    WASHINGTON,DC20005     		NONE PC HEALTHY YOUNG AMERICA-NORTHERN VIRGINIA CAMPAIGN 87,500
    YOUTH FOR TOMORROW
    11835 HAZEL CIRCLE DRIVE
    BRISTOW,VA20136     		NONE PC YFT MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES FOR THE UNDERSERVED 80,000
    YOUTH FOR TOMORROW
    11835 HAZEL CIRCLE DRIVE
    BRISTOW,VA20136     		NONE PC YFT MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES FOR THE UNDERSERVED 105,000
    Total .................................bullet 3a 5,159,651
    bApproved for future payment
    ACTION IN COMMUNITY THROUGH SERVICE
    3900 ACTS LANE
    DUMFRIES,VA22026     		NONE PC BEHAVIORAL HEALTH TREATMENT FOR HOMELESS CLIENTS 34,638
    CONSUMER HEALTH FOUNDATION-REGIONAL PRIMARY CARE COALITION
    1400 16TH STREET NW SUITE 710
    WASHINGTON,DC20036     		NONE PC REGIONAL PRIMARY CARE COALITION 7,112
    GEORGE MASON UNIVERSITY
    10900 UNIVERSITY BOULEVARD MS 4E5
    MANASSAS,VA20110     		NONE PC A FAMILY-BASED EMPOWERMENT PROGRAM TO TARGET EARLY TREATMENT FOR CHILDHOOD OBESITY IN LOW INCOME LATINO COMMUNITIES 38,153
    GREATER PRINCE WILLIAM COMMUNITY HEALTH CENTER
    4379 RIDGEWOOD CENTER DRIVE SUITE
    102
    WOODBRIDGE,VA22192     		NONE PC BRIDGING THE BEHAVIORAL HEALTH GAP - GPWCHC/GMU PRECEPTORSHIP PIPELINE 45,000
    GREATER PRINCE WILLIAM COMMUNITY HEALTH CENTER
    4379 RIDGEWOOD CENTER DRIVE SUITE
    102
    WOODBRIDGE,VA22192     		NONE PC GENERAL OPERATING SUPPORT 15,000
    INOVA HEALTH CARE SERVICES
    2740 PROSPERITY AVENUE SUITE 200
    FAIRFAX,VA22031     		NONE PC EXPANDING BEHAVIORAL HEALTH SERVICE CAPACITY IN PRINCE WILLIAM COUNTY 49,861
    LLOYD F MOSS FREE CLINIC
    1301 SAM PERRY BOULEVARD
    FREDERICKSBURG,VA22401     		NONE PC GENERAL OPERATING SUPPORT 15,500
    NATIONAL CAPITAL POISON CENTER
    3201 NEW MEXICO AVENUE SUITE 310
    WASHINGTON,DC20016     		NONE PC GENERAL OPERATING SUPPORT 6,000
    NATIONAL COALITION OF 100 BLACK WOMEN
    PO BOX 1166
    DUMFRIES,VA22026     		NONE PC RESPONDING & PROTECTING (RAP) MIDDLE SCHOOL STUDENTS AND PARENTS 43,200
    NORTHERN VIRGINIA FAMILY SERVICE
    10455 WHITE GRANITE DRIVE SUITE 100
    OAKTON,VA22124     		NONE PC GENERAL OPERATING SUPPORT 3,500
    NORTHERN VIRGINIA FAMILY SERVICE
    10455 WHITE GRANITE DRIVE SUITE 100
    OAKTON,VA22124     		NONE PC MENTAL HEALTH FOR FAMILIES WITH CHILDREN 37,328
    NOVA SCRIPTSCENTRAL INC
    6400 ARLINGTON BOULEVARD SUITE 120
    FALLS CHURCH,VA22042     		NONE PC GENERAL OPERATING SUPPORT 22,141
    NUEVA VIDA
    5225 WISCONSIN AVENUE NW SUITE 503
    WASHINGTON,DC20015     		NONE PC INCREASING CANCER PREVENTION AND IMPROVING CONTINUITY OF CARE TO UNDERSERVED LATINAS IN PWC 29,233
    PATHWAY HOMES
    10201 FAIRFAX BOULEVARD
    FAIRFAX,VA22030     		NONE PC PERMANENT SUPPORTIVE HOUSING FOR INDIVIDUALS WITH SERIOUS MENTAL ILLNESSES 45,000
    POSTPARTUM SUPPORT VIRGINIA
    PO BOX 7521
    ARLINGTON,VA22207     		NONE PC SUPPORT FOR WOMEN EXPERIENCING POSTPARTUM DEPRESSION 7,500
    PRINCE WILLIAM AREA FREE CLINIC
    13900 CHURCH HILL DRIVE
    WOODBRIDGE,VA22191     		NONE PC GENERAL OPERATING SUPPORT 19,003
    PRINCE WILLIAM DROP-IN CENTER
    13184 CENTERPOINTE WAY
    WOODBRIDGE,VA22192     		NONE PC OUTREACH & EDUCATION 13,200
    RX PARTNERSHIP
    2924 EMERYWOOD PARKWAY SUITE 300
    RICHMOND,VA23294     		NONE PC GENERAL OPERATING SUPPORT 2,500
    SCAN OF NORTHERN VIRGINIA
    205 S WHITING STREET SUITE 205
    ALEXANDRIA,VA22304     		NONE PC IMMIGRANT FAMILY REUNIFICATION: BUILDING RESILIENT YOUTH AND FAMILIES 31,596
    SENTARA NORTHERN VIRGINIA MEDICAL CENTER
    2300 OPITZ BOULEVARD
    WOODBRIDGE,VA22191     		NONE PC GENERAL OPERATING SUPPORT 15,000
    SENTARA NORTHERN VIRGINIA MEDICAL CENTER
    2300 OPITZ BOULEVARD
    WOODBRIDGE,VA22191     		NONE PC IN-PERSON INTERPRETER 60,390
    STAFFORD SCHOOLS HEAD START
    610 GAYLE STREET
    FALMOUTH,VA22405     		NONE PC STAFFORD CHILDREN'S HEALTH INSURANCE OUTREACH PROGRAM 4,348
    THE ARC OF GREATER PRINCE WILLIAM
    13505 HILLENDALE DRIVE
    DALE CITY,VA22193     		NONE PC INCREASE AGENCY CAPACITY TO BETTER SERVE PERSONS WHO ARE DUALLY DIAGNOSED (DD/MH) 15,000
    THE ARC OF GREATER PRINCE WILLIAMINSIGHT INC
    13505 HILLENDALE DRIVE
    DALE CITY,VA22193     		NONE PC COMPLETION OF THERAPEUTIC SERVICES 23,700
    THE ARC OF GREATER PRINCE WILLIAMINSIGHT INC
    13505 HILLENDALE DRIVE
    DALE CITY,VA22193     		NONE PC VOSAC III 29,025
    THE DOORWAYS
    612 E MARSHALL SREET
    RICHMOND,VA23219     		NONE PC PATIENT AND FAMILY ACCESS PROGRAM 11,400
    THE HOUSE INC STUDENT LEADERSHIP CENTER
    14001 CROWN COURT
    WOODBRIDGE,VA22193     		NONE PC THE OFFICE ON YOUTH MENTAL HEALTH AND WELLNESS 38,100
    VIRGINIA CENTER FOR HEALTH INNOVATION
    3831 WESTERRE PARKWAY SUITE C
    HENRICO,VA23233     		NONE PC HEALTHY MINDS, HEALTHY CHILDREN 54,736
    VIRGINIA COMMUNITY FOOD CONNECTIONS (GWRC)
    1287 CENTRAL PARK BOULEVARD
    FREDERICKSBURG,VA22401     		NONE PC FRESH FOOD ACCESS FOR COMMUNITY HEALTH 14,041
    VIRGINIA FOUNDATION FOR COMMUNITY COLLEGE EDUCATION
    101 N 14TH STREET
    RICHMOND,VA23219     		NONE PC POTOMAC HEALTH FOUNDATION FELLOWS PROGRAM 37,500
    VOICES FOR VIRGINIA'S CHILDREN
    701 E FRANKLIN STREET SUITE 807
    RICHMOND,VA23219     		NONE PC CAMPAIGN FOR CHILDREN'S MENTAL HEALTH 18,000
    WORKHOUSE ARTS FOUNDATION INC
    9518 WORKHOUSE WAY
    LORTON,VA22079     		NONE PC WORKHOUSE ARTS CENTER - MILITARY IN THE ARTS INITIATIVE 21,900
    YOUNG INVINCIBLES
    1411 K STREET NW
    WASHINGTON,DC20005     		NONE PC HEALTHY YOUNG AMERICA-NORTHERN VIRGINIA CAMPAIGN 37,500
    YOUTH FOR TOMORROW
    11835 HAZEL CIRCLE DRIVE
    BRISTOW,VA20136     		NONE PC YFT MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES FOR THE UNDERSERVED 45,000
    Total .................................bullet 3b 891,105
    Form 990-PF (2019)
    Form 990-PF (2019)
    Page 12
    Part XVI-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code     		(b)
    Amount     		(c)
    Exclusion code     		(d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments....          
    3 Interest on savings and temporary cash
    investments ...........     		    14 335  
    4 Dividends and interest from securities....     14 4,238,072  
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....          
    6 Net rental income or (loss) from personal property          
    7 Other investment income.....          
    8 Gain or (loss) from sales of assets other than
    inventory ............     		    18 1,988,727  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue: a
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e).. 0 6,227,134 0
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    6,227,134
    (See worksheet in line 13 instructions to verify calculations.)
    Part XVI-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow     		Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to
    the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
    instructions.)
    Form 990-PF (2019)
    Form 990-PF (2019)
    Page 13
    Part XVII
    Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
    1
    Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    Yes
    No
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash...................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements...........................
    1b(4)
     
    No
    (5) Loans or loan guarantees.............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.

    (a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
    2a
    Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
    described in section 501(c) (other than section 501(c)(3)) or in section 527? ...........
    b
    If "Yes," complete the following schedule.

    (a) Name of organization (b) Type of organization (c) Description of relationship
    Sign Here
    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 taxpayer) is based on all information of which preparer has any knowledge.
    Bullet Bullet
    May the IRS discuss this return
    with the preparer shown below
    (see instr.)
    Signature of officer or trustee Date Title
    Paid Preparer Use Only Print/Type preparer's name Preparer's Signature Date PTIN
    Firm's name SmallBullet
    		 Firm's EIN SmallBullet
    Firm's address SmallBullet


    		 Phone no.
    Form 990-PF (2019)
    Additional Data


    Software ID:  
    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description

    TY 2017 AccountingFeesSchedule
    Name:
    POTOMAC HEALTH FOUNDATION
    EIN:
    52-1340920
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ACCOUNTING 51,326 0   46,806

    TY 2017 InvestmentsCorpBondsSchedule
    Name:
    POTOMAC HEALTH FOUNDATION
    EIN:
    52-1340920
    Name of Bond End of Year Book Value End of Year Fair Market Value
    SEI U.S. MANAGED VOL FUND SVYAX SHARES 314677.268 4,663,517 4,663,517
    SIIT MULTI ASSET REAL RETURN FUND ENIAX SHARES 562858.962 4,514,129 4,514,129
    SEI CORE FIXED INCOME FUND #285 SCOAX SHARES 1462243.009 14,329,981 14,329,981
    SEI INSTITUTIONAL INVESTMENT TRUST HIGH YIELD BOND FUND SGYAX SHARES 379513. 3,316,948 3,316,948
    SEI SIIT OPPORTUNISTIC INCOME FD-A SEIAX SHARES 687302.922 5,622,138 5,622,138
    SIIT EMERGING MARKETS DEBT FUND SEDAX SHARES 581383.376 5,238,264 5,238,264
    SIIT ULTRA SHORT DURATION BOND FUND SUSAX SHARES 428761.517 4,266,177 4,266,177

    TY 2017 InvestmentsCorpStockSchedule
    Name:
    POTOMAC HEALTH FOUNDATION
    EIN:
    52-1340920
    Name of Stock End of Year Book Value End of Year Fair Market Value
    SEI DYNAMIC ASSET ALLOC. FUND SDLAX SHARES 284033.243 5,592,615 5,592,615
    SEI LARGE CAP FUND SLCAX SHARES 89872.084 17,903,418 17,903,418
    SEI EXTENDED MKT INDEX-A SMXAX SHARES 208435.682 3,126,535 3,126,535
    SEI EMERGING MRKTS EQ-A SMQFX SHARES 298312.282 2,819,051 2,819,051
    SEI GLOBAL MGD VOLATILITY FD SGMAX SHARES 651749.262 8,105,846 8,105,846
    SEI WORLD EQUITY EX-US FUND WEUSX SHARES 652119.515 7,944,824 7,944,824

    TY 2017 InvestmentsOtherSchedule2
    Name:
    POTOMAC HEALTH FOUNDATION
    EIN:
    52-1340920
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    SEI CORE PROPERTY FUND LP SHARES 6569.866 FMV 15,141,921 15,141,921
    SEI SPECIAL SITUATIONS FUND LTD SHARES 2903.787 FMV 4,302,601 4,302,601
    SEI GPA IV PRIVATE EQUITY FUND (GLOBAL PRIVATE ASSETS) SHARES 443200.14 FMV 443,200 443,200

    TY 2017 LandEtcSchedule2
    Name:
    POTOMAC HEALTH FOUNDATION
    EIN:
    52-1340920
    Category / Item Cost / Other Basis Accumulated Depreciation Book Value End of Year Fair Market Value
    FURNITURE, EQUIPMENT AND TECHNOLOGY 47,098 40,713 6,385 6,385


    TY 2017 LegalFeesSchedule
    Name:
    POTOMAC HEALTH FOUNDATION
    EIN:
    52-1340920
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    LEGAL 3,576 0   3,080


    TY 2017 OtherDecreasesSchedule
    Name:
    POTOMAC HEALTH FOUNDATION
    EIN:
    52-1340920
    Description Amount
    UNREALIZED LOSS 3,830,510


    TY 2017 OtherExpensesSchedule
    Name:
    POTOMAC HEALTH FOUNDATION
    EIN:
    52-1340920
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    PROFESSIONAL DEVELOPMENT 34,094 0   43,948
    TECH EXPENSE 17,847 0   19,514
    OTHER EXPENSE 10,474 53   -37,557
    INSURANCE 2,207 0   2,207
    SEI CORE PROPERTY FUND, LP OTHER DEDUCTIONS 0 50,419   0


    TY 2017 OtherLiabilitiesSchedule
    Name:
    POTOMAC HEALTH FOUNDATION
    EIN:
    52-1340920
    Description Beginning of Year - Book Value End of Year - Book Value
    DUE TO RELATED PARTY 24,686 27,927
    DEFERRED TAX LIABILITY 161,904 123,599


    TY 2017 OtherProfessionalFeesSchedule
    Name:
    POTOMAC HEALTH FOUNDATION
    EIN:
    52-1340920
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    INVESTMENT MANAGEMENT FEES 596,085 596,085   0
    CONSULTANT FEES 42,550 0   78,550


    TY 2017 TaxesSchedule
    Name:
    POTOMAC HEALTH FOUNDATION
    EIN:
    52-1340920
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    EXCISE TAX 66,877 0   0