TY 2018 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) PETER J LYNCH...................................................................... CHAIR	3.00 ................. 0.00	X	X	0	0
(2) STEVEN DUTKA...................................................................... VICE CHAIR	3.00 ................. 0.00	X	X	0	0
(3) DAVID SATO...................................................................... SECRETARY	3.00 ................. 0.00	X	X	0	0
(4) EDWARD A ROMANO...................................................................... TREASURER	3.00 ................. 0.00	X	X	0	0
(5) SUSAN DOLBERT...................................................................... PRESIDENT	58.00 ................. 6.00	X	X	564,231	141,501
(6) POURIA ABBASSI...................................................................... DIRECTOR	3.00 ................. 0.00	X		0	0
(7) SISTER SHEILA BROWNE...................................................................... DIRECTOR	3.00 ................. 0.00	X		0	0
(8) THOMAS BRUEHL...................................................................... VICE CHAIR	3.00 ................. 0.00	X		0	0
(9) NORMAN COULSON...................................................................... DIRECTOR	3.00 ................. 0.00	X		0	0
(10) JAMES DAL POZZO...................................................................... DIRECTOR	3.00 ................. 0.00	X		0	0
(11) JAMES EINZIGER...................................................................... DIRECTOR	3.00 ................. 0.00	X		0	0
(12) HONORABLE MITCH ENGLANDER...................................................................... DIRECTOR	3.00 ................. 0.00	X		0	0
(13) ALBERT J GHIRARDELLI ESQ...................................................................... DIRECTOR	3.00 ................. 0.00	X		0	0
(14) MARCIA HAYNES...................................................................... DIRECTOR	3.00 ................. 0.00	X		0	0
(15) BRADLEY D HOWARD...................................................................... DIRECTOR	3.00 ................. 0.00	X		0	0
(16) SARAH KARZEL...................................................................... DIRECTOR	3.00 ................. 0.00	X		0	0
(17) MICHAEL J MADDEN...................................................................... DIRECTOR	3.00 ................. 0.00	X		0	0

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

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

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

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

PROVIDENCE HEALTH & SERVICES FOUNDATION
SAN FERNANDO & SANTA CLARITA VALLEYS SA

Employer identification number

95-3544877

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

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

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2018

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv), 170(b)(1)(A)(vi), and 170(b)(1)(A)(ix)
(Complete only if you checked the box on line 5, 7, 8, or 9 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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..	20,124,483	26,449,820	17,504,833	34,281,495	23,098,321	121,458,952
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	20,124,483	26,449,820	17,504,833	34,281,495	23,098,321	121,458,952
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)..						46,211,807
6	Public support. Subtract line 5 from line 4.						75,247,145

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
7	Amounts from line 4..	20,124,483	26,449,820	17,504,833	34,281,495	23,098,321	121,458,952
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...	864,004	1,211,374	95,645	1,617,024	2,333,652	6,121,699
9	Net income from unrelated business activities, whether or not the business is regularly carried on..		115,745	100,623	137,267	48,784	402,419
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10						127,983,070

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2018 (line 6, column (f) divided by line 11, column (f)) .........

58.790 %

Public support percentage for 2017 Schedule A, Part II, line 14 ...............

76.450 %

16a

33 1/3% support test—2018. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2017. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2017. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2018

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2018 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2017 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2018 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2017 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2018. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2017. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2018

Page 4

Part IV

Supporting Organizations

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

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

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

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

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2018

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

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

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2018

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2018

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2018 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2018	(iii) Distributable Amount for 2018
1 Distributable amount for 2018 from Section C, line 6
2 Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2018:
a From 2013.......
b From 2014.......
c From 2015.......
d From 2016.......
e From 2017.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2018 distributable amount
i Carryover from 2013 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2018 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2018 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2018, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2018. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2019. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2014......
b Excess from 2015.....
c Excess from 2016.....
d Excess from 2017.....
e Excess from 2018.....

Schedule A (Form 990 or 990-EZ) (2018)

Schedule A (Form 990 or 990-EZ) 2018

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

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

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

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

OMB No. 1545-0047

2018

Name of the organization

PROVIDENCE HEALTH & SERVICES FOUNDATION
SAN FERNANDO & SANTA CLARITA VALLEYS SA

Employer identification number

95-3544877

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution. An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

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

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2

Name of organization PROVIDENCE HEALTH & SERVICES FOUNDATION SAN FERNANDO & SANTA CLARITA VALLEYS SA

Part I	Contributors (See instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 3

Name of organization PROVIDENCE HEALTH & SERVICES FOUNDATION SAN FERNANDO & SANTA CLARITA VALLEYS SA		Employer identification number 95-3544877

Part II	Noncash Property (See instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 4


Name of organization PROVIDENCE HEALTH & SERVICES FOUNDATION SAN FERNANDO & SANTA CLARITA VALLEYS SA			Employer identification number 95-3544877
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

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

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

PROVIDENCE HEALTH & SERVICES FOUNDATION
SAN FERNANDO & SANTA CLARITA VALLEYS SA

Employer identification number

95-3544877

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(b) Funds and other accounts
1	Total number at end of year .........	1
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........	3,097,277

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

$ 185,094

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 (ASC 958) relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

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

Cat. No. 52283D

Schedule D (Form 990) 2018

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....	7,072,480	6,919,973	6,714,000	5,782,000	2,489,000
b	Contributions ...	495	48,905	10,800	785,000	3,153,000
c	Net investment earnings, gains, and losses	-47,987	138,541	223,042	177,000	140,000
d	Grants or scholarships ...	21,175	34,939	27,869	30,000
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......	7,003,813	7,072,480	6,919,973	6,714,000	5,782,000

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

Board designated or quasi-endowment SchDMd Bullet

44.220 %

Permanent endowment SchDMd Bullet

53.140 %

Temporarily restricted endowment SchDMd Bullet

2.640 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations .................

3a(i)

(ii) related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....
b	Buildings ....	900,000			900,000
c	Leasehold improvements
d	Equipment ....		330,474	323,785	6,689
e	Other .....
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..					906,689

Schedule D (Form 990) 2018

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

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

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

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

Part IX

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

(a) Description				(b) Book value
(1) ARTWORK, BOOKS				185,094
(2) GIFT ANNUITIES				1,073,496
(3) CHARITABLE REMAINDER TRUSTS				9,406,762
(4) LIFE INSURANCE				16,774
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				10,682,126

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
RESERVE-CHARITABLE GIFT ANNUITIES	536,789
DUE TO AFFILIATES	149,611
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	686,400
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2018

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference

Explanation

Part III, Line 4:

ARTWORK RECEIVED THROUGH THE FOUNDATION IS DISPLAYED THROUGHOUT THE HOSPITALS TO ENHANCE THE ENVIRONMENT FOR THE PATIENTS AND THEIR FAMILIES.

Part V, Line 4:

THERE ARE THREE MAIN ENDOWMENTS. AT PROVIDENCE HOLY CROSS MEDICAL CENTER THERE IS A NURSING EXCELLENCE ENDOWMENT. THE INVESTMENT INCOME FROM THIS ENDOWMENT SUPPORTS NURSING EDUCATION AND EXCELLENCE. AT PROVIDENCE SAINT JOSEPH MEDICAL CENTER THERE IS A PATIENT CARE ENDOWMENT. THE INVESTMENT INCOME FROM THIS ENDOWMENT SUPPORTS PATIENT CARE TECHNOLOGY. THE THIRD ENDOWMENT IS A CANCER CENTER ENDOWMENT. THE INVESTMENT INCOME FROM THIS IS USED TO FUND OPERATING AND CAPITAL COSTS FOR THE CANCER CENTER.

Schedule D (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrow

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

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

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization
PROVIDENCE HEALTH & SERVICES FOUNDATION
SAN FERNANDO & SANTA CLARITA VALLEYS SA

Employer identification number

95-3544877

Part I

Fundraising Activities. Complete if the organization answered "Yes" on Form 990, Part IV, line 17.

Form 990-EZ filers are not required to complete this part.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

YesNo

If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










Total . . . . . . . . . . . . . . . . . . . .

List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.

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

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2018

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.

		(a) Event #1 GOLF EVENT (event type)	(b) Event #2 GUILD EVENTS (event type)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	366,553	135,613	502,166
2	Less: Contributions . . . .	257,293	9,795	267,088
3	Gross income (line 1 minus line 2) . . . . . .	109,260	125,818	235,078

4	Cash prizes . . . . .
5	Noncash prizes . . . .	15,049	120	15,169
6	Rent/facility costs . . . .	49,680	37,681	87,361
7	Food and beverages . . .	48,312	3,987	52,299
8	Entertainment . . . .	2,000		2,000
9	Other direct expenses . . .	12,948	62,490	75,438
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .			232,267
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .			2,811

Part III

Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

		(a) Bingo	(b) Pull tabs/Instant bingo/progressive bingo	(c) Other gaming	(d) Total gaming (add col.(a) through col.(c))
1	Gross revenue . . . . .			46,245	46,245

2	Cash prizes . . . . .
3	Noncash prizes . . . .
4	Rent/facility costs . . . .
5	Other direct expenses . . .	272	272

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes95.000 %
	No

Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow

272

Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow

45,973

Enter the state(s) in which the organization conducts gaming activities: CA

Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .

YesNo

If "No," explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .

YesNo

If "Yes," explain:

Schedule G (Form 990 or 990-EZ) 2018

Page 3

Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? . . . . . . . . . . . . . . . . .

YesNo

Indicate the percentage of gaming activity conducted in:

The organization's facility . . . . . . . . . . . . . . . . . .

13a

An outside facility . . . . . . . . . . . . . . . . . . . .

13b

100.000 %

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

GERTIE MCDEVITT

Address

501 S BUENA VISTA ST
BURBANK,CA91505

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? . . . . . . . . . . . . . . . . . . . . . . . .

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

JAN MARIE PERRY

Gaming manager compensation right arrow

$ 0

Description of services provided right arrow

OVERSEE THE PROCEDURES TO ORGANIZE AND EXECUTE THE RAFFLES AND AWARDS.

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? . . . . . . . . . . . . . . . . . . .

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additional information. See instructions.

Return Reference	Explanation

Schedule G (Form 990 or 990-EZ) 2018

Additional Data

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Software Version:

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

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

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

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
PROVIDENCE HEALTH & SERVICES FOUNDATION
SAN FERNANDO & SANTA CLARITA VALLEYS SA

Employer identification number
95-3544877

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057	51-0216586	501 (C) (3)	6,787,147	SUPPORT OPERATIONS
(2) PROVIDENCE TRINITYCARE HOSPICE 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057	95-3264139	501 (C) (3)	142,798	SUPPORT OPERATIONS
(3) CHILD DEVELOPMENT INSTITUTE 6340 VARIEL SUITE A WOODLAND HILLS,CA91367	95-4545540	501 (C) (3)	100,000	SUPPORT MENTAL HEALTH SERVICES
(4) JOHN WAYNE CANCER INSTITUTE 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057	95-4291515	501 (C) (3)	93,385	SUPPORT OPERATIONS

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

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

Cat. No. 50055P

Schedule I (Form 990) 2018

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

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

(1) SUPPORT OF CLINICS THAT PROVIDE MEDICAL SERVICES FOR THOSE UNABLE TO PAY	445	131,006	COST	LAB WORK, X-RAYS, AND OTHER MEDICAL SERVICES FOR INDIVIDUALS WHO ARE UNABLE TO PAY FOR THE SERVICES
(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference

Explanation

Part I, Line 2:

IN THE APPLICATION FOR SUPPORT, WE REQUEST A DETAILED EXPLANATION OF THE KIND OF SERVICES PROVIDED TO THE COMMUNITY ALONG WITH SPECIFIC FINANCIAL DATA. IF THE APPLICATION FOR SUPPORT IS APPROVED, WE SEND A LETTER INDICATING THE AMOUNT OF THE SUPPORT ALONG WITH A REQUEST FOR DOCUMENTATION OF HOW THE FUNDS WERE USED, ALONG WITH A REPORT OF THE NUMBER OF CHILDREN/FAMILIES SERVED OVER THE YEAR. GRANTS MADE TO AFFILIATED FOUNDATIONS ARE MONITORED ON A MONTHLY BASIS SINCE THE FINANCIAL STATEMENTS OF THESE ORGANIZATIONS ARE READILY AVAILABLE. OTHER GRANTS ARE MADE THAT COMPLY WITH THE MISSION AND FURTHER THE TAX EXEMPT PURPOSE OF THE ORGANIZATION.

Schedule I (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

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

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

Attach to Form 990.
SchJMediumBullet

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

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

PROVIDENCE HEALTH & SERVICES FOUNDATION
SAN FERNANDO & SANTA CLARITA VALLEYS SA

Employer identification number

95-3544877

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

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

Cat. No. 50053T

Schedule J (Form 990) 2018

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1SUSAN DOLBERT PRESIDENT	(i) (ii)	0 ------------- 432,338	0 ------------- 79,650	0 ------------- 52,243	0 ------------- 118,166	0 ------------- 23,335	0 ------------- 705,732	0 ------------- 20,529
2ERIK WEXLER DIRECTOR	(i) (ii)	0 ------------- 886,410	0 ------------- 569,874	0 ------------- 108,901	0 ------------- 716,756	0 ------------- 16,267	0 ------------- 2,298,208	0 ------------- 0
3PATRICIA E MODRZEJEWSKI FORMER PRESIDENT	(i) (ii)	0 ------------- 193,433	0 ------------- 212,118	0 ------------- 70,225	0 ------------- 6,788	0 ------------- 10,888	0 ------------- 493,452	0 ------------- 45,620

Schedule J (Form 990) 2018

Page 3

Part III

Supplemental Information

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

Return Reference	Explanation
Part I, Line 3	THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/TOP MANAGEMENT OFFICIAL IS PAID BY ITS TAX EXEMPT PARENT, PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O, PART VI, LINE 15A FOR THE PROCESS USED BY PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA.
Part I, Line 4b	NONQUALIFIED RETIREMENT PLAN ENTITIES WITHIN THE PSJH SYSTEM SPONSOR NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS FOR CERTAIN EXECUTIVES. THE PLANS PROVIDE FOR EMPLOYER CONTRIBUTIONS BASED ON A PERCENTAGE OF EXECUTIVE BASE SALARY AND, DEPENDING ON THE PLAN, ARE SUBJECT TO EITHER A THREE YEAR, AGE 59 1/2 OR A FIVE YEAR, AGE 65 VESTING SCHEDULE. CERTAIN EXECUTIVES PARTICIPATE IN A NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN PROVIDED BY A RELATED ENTITY. THE AMOUNTS SHOWN IN COLUMN F OF PART II REFLECT CURRENT YEAR PAYOUTS FROM THESE PLANS.
FORM 990, SCHEDULE J, PART II - EXECUTIVE INCENTIVE PROGRAM	THE PROVIDENCE EXECUTIVE INCENTIVE PROGRAM PROVIDES A LUMP SUM AWARD ANNUALLY AS A PERCENT OF THE EXECUTIVE'S BASE PAY. PERCENT OPPORTUNITIES ARE ALIGNED WITH OUR TOTAL COMPENSATION PHILOSOPHY AS OUTLINED IN PART VI, SECTION B, LINE 15 (PROCESS FOR DETERMINING COMPENSATION OF TOP MANAGEMENT, OFFICERS & KEY EMPLOYEES). FOR PROVIDENCE LEADERS, THE PERFORMANCE AWARD IS BASED ON THE LEVEL OF ACCOMPLISHMENT OF ANNUAL SYSTEM AND FUNCTIONAL (OR MARKET) OBJECTIVES. IN 2018, 60 PERCENT OF THE PARTICIPANT AWARDS WERE BASED ON PRE-DETERMINED ORGANIZATIONAL GOALS CONSISTENT WITH PROVIDENCE'S STRATEGIC PRIORITIES. IN 2018 THE PERCENT ALLOCATION FOR EACH OF THESE STRATEGIC PRIORITIES WAS AS OUTLINED BELOW: SYSTEM GOALS: FIRST-YEAR TURNOVER - 10% INPATIENT EXPERIENCE - 5% PATIENT EXPERIENCE - 5% MEDICAL GROUP PATIENT EXPERIENCE - 5% COMMUNITY BENEFIT - 10% CLINICAL EXCELLENCE - 15% FREE CASH FLOW - 10% THE REMAINING 40% WAS BASED ON A ROBUST SET OF FUNCTION SPECIFIC GOALS DESIGNED TO ALIGN CRITICAL MISSION AND BUSINESS DRIVERS.

Schedule J (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

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

Attach to Form 990.
Right pointing arrow large image

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

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

PROVIDENCE HEALTH & SERVICES FOUNDATION
SAN FERNANDO & SANTA CLARITA VALLEYS SA

Employer identification number

95-3544877

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .	X	9	70,256	FAIR MARKET VALUE
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..	X	1	900,000	FAIR MARKET VALUE
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( ISRAELI BONDS )	X	1	5,100	FAIR MARKET VALUE
26 Other ( )
27 Other ( )
28 Other ( )

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

Yes

30a

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

30a

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

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

Yes

32a

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

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

32a

If "Yes," describe in Part II.

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

describe in Part II.

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

Cat. No. 51227J

Schedule M (Form 990) (2018)

Page 2

Part II

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

Return Reference	Explanation
Part I, Line 30b:	SCHEDULE M, PART I, COLUMN (B): THE AMOUNTS SHOWN ON PART I, COL. B REFLECT THE NUMBER OF DONATIONS RECEIVED OF THE SPECIFIC TYPE OF ITEM.

Schedule M (Form 990) (2018)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

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

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

PROVIDENCE HEALTH & SERVICES FOUNDATION
SAN FERNANDO & SANTA CLARITA VALLEYS SA

Employer identification number

95-3544877

Return Reference	Explanation
Form 990, Part VI, Section A, line 6	DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS PROVIDENCE HEALTH SYSTEM - SO. CALIFORNIA IS THE SOLE CORPORATE MEMBER OF PROVIDENCE HEALTH & SERVICES FOUNDATION SAN FERNANDO & SANTA CLARITA VALLEYS SA.
Form 990, Part VI, Section A, line 7a	DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS PROVIDENCE HEALTH & SERVICES FOUNDATION SAN FERNANDO & SANTA CLARITA VALLEYS SA HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBERS RESERVE THE RIGHT TO APPOINT DIRECTORS TO THE PROVIDENCE HEALTH & SERVICES FOUNDATION SAN FERNANDO & SANTA CLARITA VALLEYS SA BOARD. ALL DIRECTOR NOMINATIONS THAT COME FROM THE PROVIDENCE HEALTH & SERVICES FOUNDATION SAN FERNANDO & SANTA CLARITA VALLEYS SA BOARD AS NOMINATIONS MUST BE APPROVED BY PROVIDENCE HEALTH SYSTEM - SO. CALIFORNIA, AS THE CORPORATE MEMBER.
Form 990, Part VI, Section A, line 7b	THE FOLLOWING POWERS RESIDE WITH THE CORPORATE MEMBER: 1) TO ADOPT OR CHANGE THE MISSION, PHILOSOPHY, AND VALUES, INCLUDING THE STRATEGIC PLAN AND MISSION STATEMENT. 2) TO AMEND OR REPEAL THE ARTICLES OF INCORPORATION OR BYLAWS. 3) TO APPROVE THE ACQUISITION OF ASSETS, THE INCURRENCE OF INDEBTEDNESS OR THE LEASE, SALE TRANSFER, ASSIGNMENT OR ENCUMBERING OF ASSETS EXCEEDING A SPECIFIED THRESHOLD, OR THE SALE OR TRANSFER OF ANY PROPERTY WHICH MAY HAVE HISTORICAL OR RELIGIOUS SIGNIFICANCE. 4) TO APPROVE THE DISSOLUTION OR LIQUIDATION. 5) TO APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS. 6) TO APPOINT THE CERTIFIED PUBLIC ACCOUNTANTS. 7) TO APPROVE THE CLOSURE OF ANY INSTITUTION OR MAJOR ENTITY OR WORK OF THE CORPORATION.
Form 990, Part VI, Section B, line 11b	THE FORM 990 WAS PREPARED BASED ON INFORMATION RECEIVED FROM VARIOUS DEPARTMENTS OF THE ORGANIZATION INCLUDING THE FINANCE TEAM, HUMAN RESOURCES, PAYROLL, COMPLIANCE AND THE GENERAL COUNSEL'S OFFICE. THE ORGANIZATION ENGAGED AN OUTSIDE ACCOUNTING FIRM TO PREPARE THE RETURN. THE RETURN HAS BEEN REVIEWED BY AN OFFICER OF THE ORGANIZATION. A FULL COPY OF THE FORM 990 WAS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING WITH THE IRS. THE AUDIT COMMITTEE OF THE PARENT ORGANIZATION IS PROVIDED AN ANNUAL UPDATE ON THE TAX REPORTING PROCESS AND KEY DISCLOSURES.
Form 990, Part VI, Section B, line 12c	BOARD MEMBERS, SPONSORS, SENIOR LEADERS AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE ANY REAL OR POTENTIAL CONFLICT OF INTEREST (COI) IN ACCORDANCE WITH THE PSJH COI POLICY AND IN CONNECTION WITH THAT INDIVIDUAL SATISFYING HIS OR HER FIDUCIARY OBLIGATIONS TO THE ORGANIZATION. DISCLOSURES ARE MADE ANNUALLY AND/OR IF AT ANY TIME AN ACTUAL, REAL OR POTENTIAL CONFLICT OF INTEREST ARISES. PSJH CHIEF LEGAL OFFICER AND/OR THE PSJH CHIEF RISK OFFICER, REVIEW ALL DISCLOSURES. WHERE APPROPRIATE, THE CEO AND/OR THE BOARD CHAIR CONSIDER MATTERS THAT INVOLVE SENIOR LEADERSHIP OR A BOARD MEMBER. PSJH CHIEF LEGAL OFFICER AND/OR CHIEF RISK OFFICER REVIEW MATTERS WHERE CONFLICT IS DIFFICULT OR CANNOT BE RESOLVED AND PRESENT RECOMMENDATIONS TO THE APPROPRIATE BOARD COMMITTEE OR THE CEO, FOR DISCUSSION AND RESOLUTION. WHEN APPROPRIATE, THE INDIVIDUAL WITH THE REAL/POTENTIAL CONFLICT THAT IS BEING REVIEWED MAY PARTICIPATE IN THE DISCUSSION BUT IS EXCUSED FROM THE MEETING WHEN ACTION IS DECIDED. WHERE APPROPRIATE, THE CHIEF RISK OFFICER OR CHIEF LEGAL OFFICER WILL PROVIDE PLAN TO MANAGE CONFLICTS. AUDITING AND MONITORING OF THIS PROCESS IS DONE PERIODICALLY. ALL DOCUMENTATION OF COI DISCLOSURES IS RETAINED PER ORGANIZATION RETENTION POLICY.
Form 990, Part VI, Section B, line 15	THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/PRESIDENT/EXECUTIVE DIRECTOR IS PAID BY ITS TAX EXEMPT PARENT, PROVIDENCE HEALTH SYSTEM SOUTHERN CALIFORNIA, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. IT IS PROVIDENCE ST. JOSEPH HEALTH'S INTENTION TO MAKE FINANCIAL INFORMATION ACCESSIBLE AND TRANSPARENT. ALTHOUGH THE FILING OF FORM 990 PROVIDES INSIGHT INTO HOW PROVIDENCE ST. JOSEPH HEALTH ACHIEVES ITS MISSION, DELIVERS ITS PROGRAMS AND STEWARDS ITS FINANCES, DECIPHERING THE INFORMATION DIRECTLY FROM FORM 990 CAN BE CHALLENGING. THE FOLLOWING PARAGRAPHS PROVIDE FURTHER INFORMATION ABOUT THE PROCESS WE USE TO DETERMINE COMPENSATION FOR TOP MANAGEMENT, OFFICERS AND KEY EMPLOYEES. PROVIDENCE ST. JOSEPH HEALTH HAS A SINGLE FIDUCIARY BOARD WITH RESPONSIBILITY FOR FINANCIAL OVERSIGHT ASSOCIATED WITH FULFILLMENT OF THE PROVIDENCE ST. JOSEPH HEALTH MISSION, DEVELOPING SYSTEM POLICIES, PROTECTING THE ASSETS ENTRUSTED TO THE ORGANIZATION AND OVERSEEING THE STRATEGIC AND OPERATIONAL AFFAIRS OF PROVIDENCE ST. JOSEPH HEALTH'S LEGAL ENTITIES. PROVIDENCE ST. JOSEPH HEALTH ALSO MAINTAINS A NETWORK OF COMMUNITY ENTITY BOARDS WITH RESPONSIBILITY FOR QUALITY OF CARE OVERSIGHT, COMMUNITY RELATIONS, ADVOCACY AND COMMUNITY NEEDS ASSESSMENTS. PROVIDENCE ST. JOSEPH HEALTH HAS A CONSISTENT COMPENSATION PHILOSOPHY FOR ALL OF ITS OFFICERS, INCLUDING OUR SENIOR EXECUTIVES. SALARIES FOR SENIOR EXECUTIVES ARE REVIEWED BY THE PROVIDENCE ST. JOSEPH HEALTH COMMITTEE. THE BOARD RETAINS AN INDEPENDENT CONSULTANT EACH YEAR TO REVIEW SALARIES OF THOSE IN THE MOST SIGNIFICANT LEADERSHIP ROLES IN THE ORGANIZATION. PART OF THE CONSULTANT'S ROLE IS TO REVIEW AN EXTENSIVE ARRAY OF COMPENSATION SURVEYS OF LARGE, NOT-FOR-PROFIT HEALTH CARE SYSTEMS IN THE UNITED STATES. PROVIDENCE ST. JOSEPH HEALTH IS ONE OF THE LARGER HEALTH SYSTEMS IN THE COUNTRY, AND AS SUCH, THE BOARD BENCHMARKS EXECUTIVE COMPENSATION AGAINST OTHER LARGE, NOT-FOR-PROFIT HEALTH SYSTEMS WHOSE REVENUE IS SIMILAR TO THAT OF PROVIDENCE ST. JOSEPH HEALTH. ADDITIONALLY, PROVIDENCE ST. JOSEPH HEALTH'S LABOR MARKET CONTINUES TO SPREAD ACROSS HEALTH CARE AND INTO GENERAL INDUSTRY. BECAUSE OF THIS, PROVIDENCE ST. JOSEPH HEALTH ALSO TAKES INTO CONSIDERATION GENERAL INDUSTRY FOR-PROFIT MARKET DATA, WHERE APPLICABLE. BASE SALARIES FOR PROVIDENCE ST. JOSEPH HEALTH EXECUTIVES ARE GENERALLY TARGETED TO THE MEDIAN LEVEL OF THE MARKET, AS IDENTIFIED BY THE INDEPENDENT CONSULTANT AND REVIEWED WITH THE EXECUTIVE COMPENSATION COMMITTEE. THE PRESIDENT/CEO UTILIZES THE MARKET INFORMATION PROVIDED BY THE CONSULTANT ALONG WITH FORMAL PERFORMANCE EVALUATIONS, TO DETERMINE SALARY RECOMMENDATIONS FOR OTHER SENIOR EXECUTIVES. THIS PROCESS INCLUDES A RIGOROUS ANALYSIS OF THOSE RECOMMENDATIONS WITH THE EXECUTIVE COMPENSATION COMMITTEE AS A PART OF THE REVIEW AND APPROVAL PROCESS. PERFORMANCE INCENTIVES ALLOW EXECUTIVES TO EARN ADDITIONAL COMPENSATION IF THEY ACHIEVE SPECIFIC ORGANIZATIONAL GOALS FOR FURTHERING PROVIDENCE ST. JOSEPH HEALTH OPERATING COMMITMENTS AND STRATEGIC OBJECTIVES. THE BOARD OF DIRECTORS CONDUCTS A THOROUGH REVIEW PROCESS TO ENSURE PERFORMANCE INCENTIVES ARE ALIGNED WITH APPROPRIATE MARKET PRACTICES. THE BOARD'S PROCESS FOR EXECUTIVE COMPENSATION FULLY COMPLIES WITH IRS STANDARDS AND MIRRORS BEST PRACTICES. THE PROCESS TO REVIEW COMPENSATION WAS LAST COMPLETED MARCH 5, 2019.
Form 990, Part VI, Section C, line 19	THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE PSJH COMMUNITY BENEFIT REPORTS, FINANCIAL REPORTS, AND PHILANTHROPY REPORTS ARE ALSO AVAILABLE ON THE PSJH INTERNET SITE.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

PROVIDENCE HEALTH & SERVICES FOUNDATION
SAN FERNANDO & SANTA CLARITA VALLEYS SA

Employer identification number

95-3544877

Part I

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

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) PHSF REALTY LLC 501 S BUENA VISTA ST BURBANK,CA91505 27-3652988	INVESTMENT	CA	44,929	0	PROVIDENCE HEALTH & SERVICES FOUNDATION SAN FERNANDO & SANTA CLARITA VALLEY

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)COVENANT ACO 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 61-1573313	HEALTHCARE	TX	501(c)(3)	12,I	CHS	Yes
(2)COVENANT HEALTH NETWORK INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 46-1259908	HEALTHCARE	CA	501(c)(3)	12,III	SJHS	Yes
(3)COVENANT HEALTH PARTNERS 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 46-3516417	HEALTHCARE	TX	501(c)(3)	12,I	CHS	Yes
(4)COVENANT HEALTH SYSTEM 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 75-2765566	HEALTHCARE	TX	501(c)(3)	3	SJHS	Yes
(5)COVENANT HEALTH SYSTEM FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 75-2897026	HEALTHCARE	TX	501(c)(3)	7	CHS	Yes
(6)COVENANT MEDICAL CENTER 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 82-2913146	HEALTHCARE	TX	501(c)(3)	3	CHS	Yes
(7)COVENANT MEDICAL GROUP 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 75-2743883	HEALTHCARE	TX	501(c)(3)	3	CHS	Yes
(8)E WA & MT UNEMPLOYMENT COMPENSATION INSURANCE TRUST 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-1082119	UNEMPLOYMENT	WA	501(c)(3)	12,I	PHS WA	Yes
(9)EVERETT TRANSITIONAL CARE SERVICES PO BOX 5128 EVERETT,WA982065128 94-3264605	TRANS. CARE	WA	501(c)(3)	10	N/A		No
(10)FACEY MEDICAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 95-4322584	SUPPORT	CA	501(c)(3)	7	PHS SOCAL	Yes
(11)GAMELIN WASHINGTON ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 20-1910170	SUPPORT	WA	501(c)(3)	7	PHS WA	Yes
(12)GLOBAL TO LOCAL HEALTH INITIATIVE 2800 SOUTH 192ND ST 104 SEATAC,WA98188 27-3133200	HEALTHCARE	WA	501(c)(3)	7	SHS	Yes
(13)HMTS INC 1 HOAG DRIVE PO BOX 6100 NEWPORT BEACH,CA926586100 45-3583707	HEALTHCARE	CA	501(c)(3)	12,I	HMHP	Yes
(14)HOAG CHARITY SPORTS 2081 BUSINESS CENTER DR STE 195 IRVINE,CA92612 45-2982422	SUPPORT	CA	501(c)(3)	7	HHF	Yes
(15)HOAG CLINIC 1 HOAG DRIVE PO BOX 6100 NEWPORT BEACH,CA926586100 33-0676831	HEALTHCARE	CA	501(c)(3)	10	HMHP	Yes
(16)HOAG HOSPITAL FOUNDATION 330 PLACENTIA AVE NEWPORT BEACH,CA92663 95-3222343	FUNDRAISING	CA	501(c)(3)	7	HMHP	Yes
(17)HOAG MEMORIAL HOSPITAL PRESBYTERIAN 1 HOAG DRIVE PO BOX 6100 NEWPORT BEACH,CA926586100 95-1643327	HEALTHCARE	CA	501(c)(3)	3	CHN	Yes
(18)HOSPICE OF LUBBOCK 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 75-2133781	HEALTHCARE	TX	501(c)(3)	10	CHS	Yes
(19)INLAND NORTHWEST HEALTH SERVICES 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-1307555	HEALTHCARE	WA	501(c)(3)	3	PHS WA	Yes
(20)INSTITUTE FOR MENTAL HEALTH & WELLNESS 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 81-4260130	HEALTHCARE	WA	501(c)(3)	7	PHS SJHS	Yes
(21)INSTITUTE FOR SYSTEMS BIOLOGY 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-2003593	HEALTHCARE	WA	501(c)(3)	7	WHC	Yes
(22)JOHN WAYNE CANCER INSTITUTE 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 95-4291515	HEALTHCARE	CA	501(c)(3)	4	PSJHC	Yes
(23)KADLEC AUXILIARY INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-6033089	SUPPORT	WA	501(c)(3)	12,III	KRMC	Yes
(24)KADLEC FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 23-7005501	SUPPORT	WA	501(c)(3)	12,I	KRMC	Yes
(25)KADLEC REGIONAL MEDICAL CENTER 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-0655392	HEALTHCARE	WA	501(c)(3)	3	WHC	Yes
(26)LITTLE COMPANY OF MARY ANCILLARY SERVICES CORPORATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 33-0844408	IMAGING SVCS	CA	501(c)(3)	10	PHS SOCAL	Yes
(27)LUBBOCK METHODIST HOSPITAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 75-2220963	HEALTHCARE	TX	501(c)(3)	7	CHS	Yes
(28)LUNDBERG ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-1562797	SUPPORT	OR	501(c)(3)	7	PHS OR	Yes
(29)MARSHA RIVKIN CENTER FOR OVARIAN CANCER RESEARCH 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-2054035	RESEARCH	WA	501(c)(3)	7	SHS	Yes
(30)METHODIST CHILDREN'S HOSPITAL 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 75-2428911	HEALTHCARE	TX	501(c)(3)	3	CHS	Yes
(31)METHODIST HOSPITAL LEVELLAND 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 75-2246348	HEALTHCARE	TX	501(c)(3)	3	CHS	Yes
(32)METHODIST HOSPITAL PLAINVIEW 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 75-2426010	HEALTHCARE	TX	501(c)(3)	3	CHS	Yes
(33)MISSION HOSPITAL REGIONAL MEDICAL CTR 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 95-1643360	HEALTHCARE	CA	501(c)(3)	3	CHN	Yes
(34)NORTHWEST HOPE & HEALING FOUNDATION PO BOX 16069 SEATTLE,WA98116 20-0799737	SUPPORT	WA	501(c)(3)	12,I	SHS	Yes
(35)PACMED CLINICS 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 56-2290878	HEALTHCARE	WA	501(c)(3)	10	WHC	Yes
(36)PROVIDENCE ALASKA FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 92-0093565	HEALTHCARE	AK	501(c)(3)	12,I	PHS WA	Yes
(37)PROVIDENCE BENEDICTINE NURSING CENTER FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-1940286	HEALTHCARE	OR	501(c)(3)	7	PHS OR	Yes
(38)PROVIDENCE BLANCHET ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-1789266	SUPPORT	WA	501(c)(3)	7	PHS WA	Yes
(39)PROVIDENCE CHILDREN'S HEALTH FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 93-0800140	SUPPORT	OR	501(c)(3)	7	PHS OR	Yes
(40)PROVIDENCE COMMUNITY HEALTH FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 93-0692907	HEALTHCARE	OR	501(c)(3)	7	PHS OR	Yes
(41)PROVIDENCE DETHMAN HOUSE 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 47-3385506	SUPPORT	WA	501(c)(3)	7	N/A		No
(42)PROVIDENCE GAMELIN HOUSE ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 31-1744654	SUPPORT	WA	501(c)(3)	7	PHS WA	Yes
(43)PROVIDENCE HEALTH & SERVICES 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-1549796	HEALTHCARE	WA	501(c)(3)	12,II	PSJH		No
(44)PROVIDENCE HEALTH & SERVICES - MONTANA 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 81-0231793	HEALTHCARE	MT	501(c)(3)	3	PHS WA	Yes
(45)PROVIDENCE HEALTH & SERVICES - OREGON 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 51-0216587	HEALTHCARE	OR	501(c)(3)	3	PHS	Yes
(46)PROVIDENCE HEALTH & SERVICES - WASHINGTON 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 51-0216586	HEALTHCARE	WA	501(c)(3)	3	PHS	Yes
(47)PROVIDENCE HEALTH & SERVICES - WESTERN WASHINGTON 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-1303277	HEALTHCARE	WA	501(c)(3)	3	PMWHC	Yes
(48)PROVIDENCE HEALTH ASSURANCE 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 55-0828701	MEDICAID	OR	501(c)(4)	N/A	PHP	Yes
(49)PROVIDENCE HEALTH CARE FOUNDATION - EASTERN WASHINGTON 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 32-0014330	HEALTHCARE	WA	501(c)(3)	7	PHS WA	Yes
(50)PROVIDENCE HEALTH CARE FOUNDATION (CENTRALIA) 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-1433382	HEALTHCARE	WA	501(c)(3)	7	PHS W WA	Yes
(51)PROVIDENCE HEALTH PLAN 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 93-0863097	HEALTHCARE	OR	501(c)(4)	N/A	PPP	Yes
(52)PROVIDENCE HEALTH SYSTEM - SO CALIFORNIA 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 51-0216589	HEALTHCARE	CA	501(c)(3)	3	PHS	Yes
(53)PROVIDENCE HOOD RIVER MEMORIAL HOSPITAL FOUNDATION INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 93-0921990	HEALTHCARE	OR	501(c)(3)	7	PHS OR	Yes
(54)PROVIDENCE HOSPICE AND HOME CARE FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 27-2552749	HEALTHCARE	WA	501(c)(3)	7	PHS W WA	Yes
(55)PROVIDENCE HOSPICE OF SEATTLE FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-2077378	HEALTHCARE	WA	501(c)(3)	7	PHS W WA	Yes
(56)PROVIDENCE LITTLE COMPANY OF MARY FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 51-0224944	HEALTHCARE	CA	501(c)(3)	7	PHS SOCAL	Yes
(57)PROVIDENCE MARIANWOOD FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 93-1554288	HEALTHCARE	WA	501(c)(3)	12,I	PHS W WA	Yes
(58)PROVIDENCE MEDICAL INSTITUTE 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 33-0283773	HEALTHCARE	CA	501(c)(3)	12,I	PHS SOCAL	Yes
(59)PROVIDENCE MILWAUKIE FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 94-3079515	HEALTHCARE	OR	501(c)(3)	7	PHS OR	Yes
(60)PROVIDENCE MINISTRIES 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016	RELIGIOUS ORG	WA	501(c)(3)	1	N/A		No
(61)PROVIDENCE MOUNT ST VINCENT FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-1188119	HEALTHCARE	WA	501(c)(3)	7	PHS WA	Yes
(62)PROVIDENCE NEWBERG HEALTH FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 93-0889144	HEALTHCARE	OR	501(c)(3)	7	PHS OR	Yes
(63)PROVIDENCE PETER CLAVER ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 31-1629656	SUPPORT	WA	501(c)(3)	7	PHS WA	Yes
(64)PROVIDENCE PLAN PARTNERS 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-1861964	HEALTHCARE	WA	501(c)(4)	N/A	PHS OR	Yes
(65)PROVIDENCE PORTLAND MEDICAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 93-1231494	HEALTHCARE	OR	501(c)(3)	7	PHS OR	Yes
(66)PROVIDENCE ROSSI ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 31-1584166	SUPPORT	WA	501(c)(3)	10	PHS WA	Yes
(67)PROVIDENCE SAINT JOHN'S HEALTH CENTER 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 95-1684082	HEALTHCARE	CA	501(c)(3)	3	PHS SOCAL	Yes
(68)PROVIDENCE SAINT JOHN'S MEDICAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 81-4542216	HEALTHCARE	CA	501(c)(3)	3	PHS SOCAL	Yes
(69)PROVIDENCE SEASIDE HOSPITAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 93-0927320	HEALTHCARE	OR	501(c)(3)	7	PHS OR	Yes
(70)PROVIDENCE ST ELIZABETH HOUSE ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-2171539	SUPPORT	WA	501(c)(3)	7	PHS WA	Yes
(71)PROVIDENCE ST FRANCIS ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 94-3244854	SUPPORT	WA	501(c)(3)	7	PHS WA	Yes
(72)PROVIDENCE ST JOSEPH HEALTH 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 81-1244422	HEALTHCARE	WA	501(c)(3)	12,III	N/A		No
(73)PROVIDENCE ST JOSEPH HEALTH FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 94-3078543	HEALTHCARE	WA	501(c)(3)	12,I	PHS WA	Yes
(74)PROVIDENCE ST JOSEPH MEDICAL CENTER 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 81-0463482	HEALTHCARE	MT	501(c)(3)	3	PHS WA	Yes
(75)PROVIDENCE ST MARY FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 45-2841492	HEALTHCARE	WA	501(c)(3)	7	PHS WA	Yes
(76)PROVIDENCE ST PETER FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-1097056	SUPPORT	WA	501(c)(3)	7	PHS W WA	Yes
(77)PROVIDENCE ST VINCENT MEDICAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 93-0575982	HEALTHCARE	OR	501(c)(3)	7	PHS OR	Yes
(78)PROVIDENCE TRINITYCARE HOSPICE 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 95-3264139	HEALTHCARE	CA	501(c)(3)	10	PHS SOCAL	Yes
(79)PROVIDENCE TRINITYCARE HOSPICE FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 33-0261016	HEALTHCARE	CA	501(c)(3)	7	PTCH	Yes
(80)PROVIDENCE WILLAMETTE FALLS MEDICAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 93-1003750	HEALTHCARE	OR	501(c)(3)	12, I	PHS OR	Yes
(81)QUEEN OF THE VALLEY MEDICAL CENTER 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 94-1243669	HEALTHCARE	CA	501(c)(3)	3	SJHS	Yes
(82)REDWOOD MEMORIAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 94-2779313	HEALTHCARE	CA	501(c)(3)	7	RMH	Yes
(83)REDWOOD MEMORIAL HOSPITAL 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 94-1384665	HEALTHCARE	CA	501(c)(3)	3	SJHS	Yes
(84)SAINT JOHN'S HOSPITALHEALTH CENTER FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 95-6100079	SUPPORT	CA	501(c)(3)	7	PSJHC	Yes
(85)SANTA ROSA MEMORIAL HOSPITAL 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 94-1231005	HEALTHCARE	CA	501(c)(3)	3	SJHS	Yes
(86)SEATTLE SCIENCE FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 61-1502822	PHYSN COLLAB	WA	501(c)(3)	7	WHC	Yes
(87)SISTERS OF PROVIDENCE OF MONTANA CORPORATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 26-2612415	SHELL CORP	MT	501(c)(3)	1	PHS WA		No
(88)SISTERS OF ST JOSEPH OF ORANGE 480 S BATAVIA ORANGE,CA92868 95-1643383	RELIGIOUS ORG	CA	501(c)(3)	1	N/A		No
(89)SRM ALLIANCE HOSPITAL SERVICES (PVH) 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 68-0395200	HEALTHCARE	CA	501(c)(3)	3	SRMH	Yes
(90)ST JOSEPH HEALTH MINISTRY 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 27-1666576	RELIGIOUS ORG	CA	501(c)(3)	1	SSJO		No
(91)ST JOSEPH HEALTH NORTHERN CALIFORNIA LLC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 81-4791043	HEALTHCARE	CA	501(c)(3)	3	SJHS	Yes
(92)ST JOSEPH HEALTH SYSTEM 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 95-3589356	HEALTHCARE	CA	501(c)(3)	12,I	PSJH		No
(93)ST JOSEPH HEALTH SYSTEM FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 33-0143024	HEALTHCARE	CA	501(c)(3)	7	SJHS	Yes
(94)ST JOSEPH HERITAGE HEALTHCARE 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 33-0185031	HEALTHCARE	CA	501(c)(3)	3	SJHS	Yes
(95)ST JOSEPH HOME CARE NETWORK 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 68-0331084	HEALTHCARE	CA	501(c)(3)	10	SJHS	Yes
(96)ST JOSEPH HOSPITAL OF EUREKA 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 94-1156596	HEALTHCARE	CA	501(c)(3)	3	SJHS	Yes
(97)ST JOSEPH HOSPITAL OF ORANGE 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 95-1643359	HEALTHCARE	CA	501(c)(3)	3	CHN	Yes
(98)ST JUDE HOSPITAL INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 95-1643324	HEALTHCARE	CA	501(c)(3)	3	CHN	Yes
(99)ST LUKE ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 94-3176618	SUPPORT	WA	501(c)(3)	7	PHS WA	Yes
(100)ST MARY MEDICAL CENTER 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 95-1914489	HEALTHCARE	CA	501(c)(3)	3	CHN	Yes
(101)ST MARY OF THE PLAINS HOSPITAL FDN 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 75-1653181	HEALTHCARE	TX	501(c)(3)	7	CHS	Yes
(102)ST PATRICK HOSPITAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 23-7056976	HEALTHCARE	MT	501(c)(3)	7	PHS WA	Yes
(103)ST THOMAS CHILD AND FAMILY CENTER 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 81-0233495	EDUCATION	MT	501(c)(3)	10	PHS WA	Yes
(104)SWEDISH EDMONDS 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 27-2305304	HEALTHCARE	WA	501(c)(3)	3	WHC	Yes
(105)SWEDISH HEALTH SERVICES 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-0433740	HEALTHCARE	WA	501(c)(3)	3	WHC	Yes
(106)SWEDISH MEDICAL CENTER FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-0983214	HEALTHCARE	WA	501(c)(3)	7	SHS	Yes
(107)SWEDISH MJM HOLDINGS 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 27-3139262	HOLDING CO	WA	501(c)(3)	12,I	SHS	Yes
(108)THE GAMELIN ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-1180824	SUPPORT	WA	501(c)(3)	7	PHS WA	Yes
(109)THE GAMELIN CALIFORNIA ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-1293869	SUPPORT	CA	501(c)(3)	10	PHS SOCAL	Yes
(110)THE GAMELIN OREGON ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-1214491	SUPPORT	OR	501(c)(3)	10	PHS OR	Yes
(111)UNIVERSITY OF PROVIDENCE 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 81-0231777	EDUCATION	MT	501(c)(3)	2	PHS	Yes
(112)WESTERN HEALTHCONNECT 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 45-4171900	SHELL CORPORATION	WA	501(c)(3)	12,II	PHS W WA	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2018

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	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) 20TH STREET SURGERY LLC 1301 20TH STREET STE 140 SANTA MONICA,CA90404 73-1735618	AMBULATORY SURG	CA	N/A
(2) BROADWAY IMAGING LLC 500 W BROADWAY MISSOULA,MT59802 52-2405971	MEDICAL IMAGING	MT	N/A
(3) CENTER FOR SPECIALTY SURGERY LLC 11782 SW BARNES RD PORTLAND,OR97225 26-3638838	AMBULATORY SURG	OR	N/A
(4) CLACKAMAS RADIATION ONCOLOGY CENTER LLC 4400 NE HALSEY ST BLDG II 495 PORTLAND,OR97213 26-0381897	RADIATION ONCOL	OR	N/A
(5) COASTAL ASC HOLDINGS LLC ONE HOAG DRIVE PO BOX 6100 NEWPORT BEACH,CA926586100 81-0986844	HEALTHCARE	CA	N/A
(6) COVENANT LONG-TERM CARE LP 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 20-5033419	HEALTHCARE	TX	N/A
(7) CTR FOR MED IMAGING-BRIDGEPORT LLC 4400 NE HALSEY 495 PORTLAND,OR97213 26-0796953	IMAGING DIAG.	OR	N/A
(8) CTR FOR MED IMAGING-TANASBOURNE LLC 4400 NE HALSEY 495 PORTLAND,OR97213 20-0477972	IMAGING DIAG.	OR	N/A
(9) FULLERTON SURGICAL CENTER LP 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 47-0927394	AMBULATORY SURG	CA	N/A
(10) GREATER VALLEY MEDICAL BUILDING LP 501 S BUENA VISTA ST BURBANK,CA91505 95-4570858	REAL ESTATE - MOB	CA	N/A
(11) HCSA PROPERTIES LLC 1600 M STREET NW AUBURN,WA98001 46-0620892	REAL ESTATE RENT	WA	N/A
(12) HERITAGE INVESTMENT GROUP I LLC 500 S MAIN STREET STE 1000 ORANGE,CA92868 27-1000061	INVESTMENTS	CA	N/A
(13) HOAG ORTHOPEDIC INSTITUTE ONE HOAG DRIVE PO BOX 6100 NEWPORT BEACH,CA926586100 61-1588294	HEALTHCARE	CA	N/A
(14) HOAG OUTPATIENT CENTERS LLC 27271 LAS RAMBLAS 350 MISSION VIEJO,CA92691 45-3587572	HEALTHCARE	CA	N/A
(15) INLAND IMAGING LLC 801 S STEVENS ST SPOKANE,WA99204 91-1855796	MEDICAL IMAGING	WA	N/A
(16) LSC REAL PROPERTY LLC 2301 QUAKER AVENUE LUBBOCK,TX79410 47-4646059	REAL ESTATE	TX	N/A
(17) METHODIST DIAGNOSTIC IMAGING 4005 24TH STREET LUBBOCK,TX79410 75-2343261	HEALTHCARE	TX	N/A
(18) NEWPORT BAY SURGERY CENTER LLC 3333 W PACIFIC COAST HWY STE 100 NEW PORT BEACH,CA92663 56-2518360	HEALTHCARE	CA	N/A
(19) NEWPORT BEACH ENDOSCOPY CENTER LLC 27271 LAS RAMBLAS 350 MISSION VIEJO,CA92691 77-0368744	HEALTHCARE	CA	N/A
(20) NEWPORT IMAGING CENTER 360 SAN MIGUEL NEWPORT BEACH,CA92660 33-0191776	HEALTHCARE	CA	N/A
(21) NEWPORT SURGICAL PARTNERS LLC 27271 LAS RAMBLAS 350 MISSION VIEJO,CA92691 39-2060266	HEALTHCARE	CA	N/A
(22) NORTH BAY ENDOSCOPY CENTER 1383 N MCDOWELL BLVD STE 110 PETALUMA,CA94954 61-1559876	HEALTHCARE	CA	N/A
(23) OREGON ADVANCED IMAGING LLC 881 OHARE PARKWAY MEDFORD,OR97504 45-0471748	MEDICAL IMAGING	OR	N/A
(24) OREGON OUTPATIENT SURGERY CENTER 7300 SW CHILDS RD TIGARD,OR97224 22-3883387	AMBULATORY SURG	OR	N/A
(25) PETCT IMAGING AT SWEDISH CANCER INSTITUTE LLC 1221 MADISON STREET SEATTLE,WA98104 20-3132044	MEDICAL IMAGING	WA	N/A
(26) PHS INVESTMENT TRANSITION PORTFOLIO 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 47-2279711	INVESTMENTS	WA	N/A
(27) PHS INVESTMENT TRUST 2015 PRIVATE ASSETS PORTFOLIO 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 47-3393740	INVESTMENTS	WA	N/A
(28) PHS INVESTMENT TRUST 2016 PRIVATE ASSETS PORTFOLIO 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 81-1532735	INVESTMENTS	WA	N/A
(29) PHS INVESTMENT TRUST 2016 PRIVATE RE PORTFOLIO 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 81-2960145	INVESTMENTS	WA	N/A
(30) PHS INVESTMENT TRUST BANK LOANS PORTFOLIO 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 47-2357735	INVESTMENTS	WA	N/A
(31) PHS INVESTMENT TRUST COMMODITIES PORTFOLIO 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 47-2269004	INVESTMENTS	WA	N/A
(32) PHS INVESTMENT TRUST HEDGE FUND PORTFOLIO 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 47-2293255	INVESTMENTS	WA	N/A
(33) PHS INVESTMENT TRUST LDI PORTFOLIO 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 47-2392060	INVESTMENTS	WA	N/A
(34) PHS INVESTMENT TRUST LONG TREASURIES PORTFOLIO 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 47-2385238	INVESTMENTS	WA	N/A
(35) PHS INVESTMENT TRUST MLP PORTFOLIO 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 47-2367538	INVESTMENTS	WA	N/A
(36) PHS INVESTMENT TRUST PUBLIC DEBT PORTFOLIO 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 47-2353569	INVESTMENTS	WA	N/A
(37) PHS INVESTMENT TRUST PUBLIC EQUITY PORTFOLIO 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 47-2283974	INVESTMENTS	WA	N/A
(38) PHS INVESTMENT TRUST RELATIVE VALUE PORTFOLIO 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 47-2314743	INVESTMENTS	WA	N/A
(39) PHS INVESTMENT TRUST RISK PARITY PORTFOLIO 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 47-2336377	INVESTMENTS	WA	N/A
(40) PHS INVESTMENT TRUST SHORT TERM INVESTMENT PORTFOLIO 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 81-2701056	INVESTMENTS	WA	N/A
(41) PHS INVESTMENT TRUST TACTICAL TRADING PORTFOLIO 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 47-2327491	INVESTMENTS	WA	N/A
(42) PHS INVESTMENT TRUST TIPS PORTFOLIO 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 47-2402609	INVESTMENTS	WA	N/A
(43) PORTLAND MEDICAL IMAGING LLC 4400 NE HALSEY 495 PORTLAND,OR97213 20-1054971	IMAGING DIAGNOSTICS	OR	N/A
(44) PROV RADIATION ONCOLOGY DEVELOP ASSN 4400 NE HALSEY 495 PORTLAND,OR97213 26-0682491	REAL ESTATE - MOB	OR	N/A
(45) PROVIDENCE CHILDREN'S NEONATAL SERVICES 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 47-0918549	NEONATAL CARE	WA	N/A
(46) PROVIDENCE IMAGING CENTER JOINT VENTURE 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 92-0118807	MEDICAL IMAGING	AK	N/A
(47) PROVIDENCE PARTNERS FOR HEALTH LLC 501 S BUENA VISTA ST BURBANK,CA91505 45-4041798	CLIN QUALITY/INT	CA	N/A
(48) PROVIDENCE ST JOSEPH HEALTH LONG TERM PORTFOLIO 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 82-3190634	INVESTMENTS	WA	N/A
(49) PROVIDENCE SURGERY CENTER LLC 902 N ORANGE ST MISSOULA,MT59802 84-1401625	AMBULATORY SURG	MT	N/A
(50) PROVIDENCESILVERTON REHAB LLC 4400 NE HALSEY 425 PORTLAND,OR97213 48-1287267	REHAB SERVICES	OR	N/A
(51) PROVIDENCEUSP SANTA CLARITA GP LLC 11550 INDIAN HILLS ROAD 160 MISSION HILLS,CA91345 20-2829660	AMBULATORY SURG	CA	N/A
(52) PROVIDENCEUSP SURGERY CENTERS LLC 11550 INDIAN HILLS ROAD 160 MISSION HILLS,CA91345 20-0905938	AMBULATORY SURG	CA	N/A
(53) SHA LLC 12940 NORTH HIGHWAY 183 AUSTIN,TX78750 75-2569094	HEALTHCARE	TX	N/A
(54) SJO ASC HOLDINGS LLC 1140 W LA VETA AVE ORANGE,CA92868 82-1655501	HEALTHCARE	CA	N/A
(55) ST JOSEPH PHYSICIAN VENTURES I LLC 1100 WEST STEWART DRIVE ORANGE,CA92868 45-4521884	REAL ESTATE	CA	N/A
(56) ST JOSEPHSATELLITE DIALYSIS CENTERS LLC 300 SANTANA ROW STE 300 SAN JOSE,CA95128 81-4657391	HEALTHCARE	CA	N/A
(57) ST JUDE SURGICAL CENTERS LLC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 82-3352570	AMBULATORY SURG	CA	N/A
(58) SURGERY CENTER AT TANASBOURNE LLC 11221 ROE AVE STE 300 LEAWOOD,KS66211 20-8187971	AMBULATORY SURG	KS	N/A
(59) TARZANA PEDIATRIC VENTURES LLC 18321 CLARK ST TARZANA,CA91356 82-1308306	HEALTHCARE	CA	N/A
(60) THE MADISON SPOKANE INN LLC 15 WEST ROCKWOOD BLVD SPOKANE,WA99204 84-1606484	HOTEL SERVICES	WA	N/A

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No
(1) 1221 MADISON STREET OWNERS ASSOC 747 BROADWAY SEATTLE,WA98122 20-1954319	OWNERS' ASSOC.	WA	N/A	C				No
(2) AMERICAN UNITY GROUP LTD 90 PITTS BAY ROAD HM08 PEMBROKE BD	CAPTIVE INSURANCE	BD	N/A	C				No
(3) AYIN HEALTH SOLUTIONS INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 83-3037172	HEALTHCARE	DE	N/A	C				No
(4) BOURGET HEALTH SERVICES INC PO BOX 2687 SPOKANE,WA99223 91-1354431	CLIN/MED LAB	WA	N/A	C				No
(5) CARON HEALTH CORPORATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 81-0486082	MED PHYS SVCS	MT	N/A	C				No
(6) HOAG CLINIC 1 HOAG DRIVE PO BOX 6100 NEWPORT BEACH,CA926586100 33-0676831	HEALTHCARE	CA	N/A	C				No
(7) DATU HEALTH INC AND SUBSIDIARIES 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 46-3070062	IT SVCS	DE	N/A	C				No
(8) ENDOSCOPY CENTER OF SOUTHERN CALIFORNIA 1301 20TH STREET STE 280 SANTA MONICA,CA90404 95-2880495	HEALTHCARE	CA	N/A	S				No
(9) GRACE CLINIC OF LUBBOCK 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 20-3856995	HEALTHCARE	CA	N/A	C				No
(10) GRACE CLINIC SERVICES INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 20-3857067	HEALTHCARE	TX	N/A	C				No
(11) HOAG MANAGEMENT SERVICES INC 1 HOAG DRIVE PO BOX 6100 NEWPORT BEACH,CA926586100 33-0731587	HEALTHCARE	CA	N/A	C				No
(12) LUBBOCK METHODIST HOSP PRACTICE MGMT 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 75-2578995	INACTIVE	TX	N/A	C				No
(13) LUBBOCK METHODIST HOSPITAL SVCS 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 75-2118585	HEALTHCARE	TX	N/A	C				No
(14) LUMEDIC ACQUISITION CO INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 83-3881097	HEALTHCARE	WA	N/A	C				No
(15) MISSION VIEJO MEDICAL VENTURES 27800 MEDICAL CENTER RD 354 MISSION VIEJO,CA92691 33-0212905	HEALTHCARE	CA	N/A	C				No
(16) PHN HOLDINGS 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 46-1814184	STRAT PLAN SVCS	CA	N/A	C				No
(17) PIONEER INNOVATIONS INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 36-4818191	HEALTH INNOVATNS	WA	N/A	C				No
(18) PROVIDENCE ASSURANCE INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 20-8194071	CAPTIVE INSURANCE	AZ	N/A	C				No
(19) PROVIDENCE HEALTH CARE VENTURES INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 90-0155714	CLIN/MED LAB	WA	N/A	C				No
(20) PROVIDENCE HEALTH NETWORK 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 80-0886966	PREPAID HEALTH	CA	N/A	C				No
(21) PROVIDENCE HEALTH VENTURES INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 33-0122216	INVESTMENT	CA	N/A	C				No
(22) ST JOSEPH HEALTH SOURCE INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 46-1900168	HEALTHCARE	CA	N/A	C				No
(23) ST JOSEPH HEALTH 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 46-2340232	HOLDING COMPANY	CA	N/A	C				No
(24) ST JOSEPH PROF SVCS ENTERPRSES INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 33-0155323	HEALTHCARE	CA	N/A	C				No
(25) VINSERRA INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 95-3943315	INVESTMENTS	CA	N/A	C				No
(26) WESTERN HEALTHCONNECT VENTURES INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 80-0953654	INVESTMENTS	WA	N/A	C				No
(27) YAKIMA MEDICAL ARTS INC 611 N PERRY 100 SPOKANE,WA99202 91-0787963	RENT REAL ESTATE	WA	N/A	C				No

Schedule R (Form 990) 2018

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

Yes

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved
(1) PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA	B	6,787,147
(2) PROVIDENCE TRINITYCARE HOSPICE	B	142,798
(3) PROVIDENCE HEALTH & SERVICES - WASHINGTON	C	468,000
(4) PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA	C	5,272,717
(5) WELL BEING TRUST	C	600,000
(6) JOHN WAYNE CANCER INSTITUTE	B	93,385

Schedule R (Form 990) 2018

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2018

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2018

Additional Data

Software ID:
Software Version:

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	34,281,495	23,098,321
9	Program service revenue (Part VIII, line 2g) .........	0	0
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	1,913,406	5,847,712
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	236,035	117,025
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	36,430,936	29,063,058
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	10,273,635	7,258,121
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)	3,768,507	4,220,485
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	140,031	11,400
b	Total fundraising expenses (Part IX, column (D), line 25) 4,290,154
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	1,465,143	1,521,180
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	15,647,316	13,011,186
19	Revenue less expenses. Subtract line 18 from line 12.......	20,783,620	16,051,872
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	109,624,230	118,594,450
21	Total liabilities (Part X, line 26).............	1,353,767	915,462
22	Net assets or fund balances. Subtract line 21 from line 20.....	108,270,463	117,678,988

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 6,441,701 including grants of $ 6,441,701 ) (Revenue $ 0 )
	SEE SCHEDULE OPROVIDENCE ST. JOSEPH HEALTH SYSTEMON JULY 1, 2016, PROVIDENCE HEALTH & SERVICES (PHS) AND ST. JOSEPH HEALTH SYSTEM (SJHS) ENTERED INTO A BUSINESS COMBINATION AGREEMENT. BY COMING TOGETHER, PROVIDENCE ST. JOSEPH HEALTH SEEKS TO BETTER SERVE ITS COMMUNITIES THROUGH GREATER PATIENT AFFORDABILITY, OUTSTANDING CLINICAL CARE, IMPROVEMENTS TO THE PATIENT EXPERIENCE AND INTRODUCTION OF NEW SERVICES WHERE THEY ARE NEEDED MOST. TOGETHER, OUR CAREGIVERS SERVE IN 51 HOSPITALS, 829 CLINICS ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON.THE FOUNDERS OF BOTH ORGANIZATIONS WERE COURAGEOUS WOMEN AHEAD OF THEIR TIME. THE SISTERS OF PROVIDENCE AND THE SISTERS OF ST. JOSEPH OF ORANGE BROUGHT HEALTH CARE AND OTHER SOCIAL SERVICES TO THE AMERICAN WEST WHEN IT WAS STILL A RUGGED, UNTAMED FRONTIER. NOW, AS WE FACE A DIFFERENT LANDSCAPE - A CHANGING HEALTH CARE ENVIRONMENT - WE DRAW UPON THEIR PIONEERING AND COMPASSIONATE SPIRIT TO PLAN FOR THE NEXT CENTURY OF HEALTH CARE.PROVIDENCE HEALTH & SERVICESIN 1856, MOTHER JOSEPH AND FOUR SISTERS OF PROVIDENCE ESTABLISHED HOSPITALS, SCHOOLS AND ORPHANAGES ACROSS THE NORTHWEST. OVER THE YEARS, OTHER CATHOLIC SISTERS TRANSFERRED SPONSORSHIP OF THEIR MINISTRIES TO PROVIDENCE, INCLUDING THE LITTLE COMPANY OF MARY, DOMINICANS AND CHARITY OF LEAVENWORTH. RECENTLY, SWEDISH HEALTH SERVICES, KADLEC REGIONAL MEDICAL CENTER AND PACIFIC MEDICAL CENTERS HAVE JOINED PROVIDENCE AS SECULAR PARTNERS WITH A COMMON COMMITMENT TO SERVING ALL MEMBERS OF THE COMMUNITY. TODAY, PROVIDENCE SERVES ALASKA, CALIFORNIA, MONTANA, OREGON AND WASHINGTON.ST. JOSEPH HEALTH SYSTEMIN 1912, A SMALL GROUP OF SISTERS OF ST. JOSEPH LANDED ON THE RUGGED SHORES OF EUREKA, CALIFORNIA TO PROVIDE EDUCATION AND HEALTH CARE. THEY LATER ESTABLISHED ROOTS IN ORANGE, CALIFORNIA, AND EXPANDED TO SERVE SOUTHERN CALIFORNIA, NORTHERN CALIFORNIA AND TEXAS. THE HEALTH SYSTEM ESTABLISHED MANY KEY PARTNERSHIPS, INCLUDING A MERGER BETWEEN LUBBOCK METHODIST HOSPITAL SYSTEM AND ST. MARY HOSPITAL TO FORM COVENANT HEALTH IN LUBBOCK TEXAS. RECENTLY, AN AFFILIATION WAS ESTABLISHED WITH HOAG HEALTH TO INCREASE ACCESS TO SERVICES IN ORANGE COUNTY, CALIFORNIA.REALIZING OUR MISSION - THE PURPOSE OF PROVIDENCE HEALTH & SERVICES FOUNDATION SF & SCV SA IS TO RAISE FUNDS PRIMARILY FOR PROVIDENCE SAINT JOSEPH MEDICAL CENTER, PROVIDENCE HOLY CROSS MEDICAL CENTER, AND PROVIDENCE TARZANA MEDICAL CENTER. THE MEDICAL CENTERS ARE COMMITTED TO THEIR MISSIONS OF CONTINUING THE HEALING MINISTRY OF JESUS IN THE WORLD OF TODAY WITH SPECIAL CONCERN FOR THOSE WHO ARE POOR AND VULNERABLE. THE MEDICAL CENTERS WORK IN PARTNERSHIP WITH COMMUNITY ORGANIZATIONS TO REACH OUT TO THOSE IN NEED. THROUGH THESE COLLABORATIVE EFFORTS, THEY IMPROVE ACCESS TO HEALTH CARE AND PROVIDE HEALTH EDUCATION RESOURCES IN THE SURROUNDING COMMUNITIES. DURING 2018, SOME OF THE LARGER GRANTS PAID TO THE MEDICAL CENTERS WERE USED FOR THE SAINT JOSEPH EMERGENCY DEPARTMENT CAMPAIGN ($2,300,000), WELCOME BABY PROGRAM ($1,114,748), RADIOLOGY SUITE UPGRADE ($1,000,000), CANCER RESEARCH ($317,484), NICU FOLLOW UP CLINIC ($252,967), THE PURCHASE OF TWO ULTRASOUND UNITS ($235,085) AND OTHER CAPITAL EQUIPMENT ($338,978).

4b	(Code: ) (Expenses $ 685,414 including grants of $ 685,414 ) (Revenue $ 0 )
	THE FOUNDATION MAKES DIRECT PAYMENTS TO COMMUNITY BENEFIT ORGANIZATIONS EACH YEAR. DURING 2018 THE FOUNDATION CONTRIBUTED $100,000 TO THE CHILD DEVELOPMENT INSTITUTE. IT ALSO MADE PAYMENTS TO THE MEDICAL CENTERS FOR OTHER COMMUNITY BENEFIT PROGRAMS ($585,414).

4c	(Code: ) (Expenses $ 131,006 including grants of $ 131,006 ) (Revenue $ 0 )
	THE FOUNDATION SUPPORTS CLINICS THAT PROVIDE MEDICAL SERVICES FOR THOSE WHO ARE UNABLE TO PAY FOR THE SERVICES. DURING 2018, TOTAL PAYMENTS OF $131,006 WERE MADE TO THIS PROGRAM TO PAY FOR LAB WORK, X-RAYS AND OTHER MEDICAL SERVICES FOR 445 PATIENTS.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses7,258,121

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)		(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
(A) Name and Title
(18) MICHAEL S OVERING ESQ........................................................................ DIRECTOR	3.00 .......................0.00	X		0	0	0
(19) GERALD S PUCHLIK........................................................................ DIRECTOR	3.00 .......................0.00	X		0	0	0
(20) MARIA O URIBE........................................................................ DIRECTOR	3.00 .......................0.00	X		0	0	0
(21) ERIK WEXLER........................................................................ DIRECTOR	3.00 .......................62.00	X		0	1,565,185	733,023
(22) PATRICIA E MODRZEJEWSKI........................................................................ FORMER PRESIDENT	0.00 .......................40.00		X	0	475,776	17,676

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	0	2,605,192	892,200

1	Briefly describe the organization’s mission or most significant activities: SEE SCHEDULE OAS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	21
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	19
5	Total number of individuals employed in calendar year 2018 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	279
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

(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 of compensation from the organization 0

1a	Federated campaigns..		1a	228
b	Membership dues..		1b
c	Fundraising events..		1c	267,088
d	Related organizations		1d	6,340,717
e	Government grants (contributions)		1e	1,447,622

f	All other contributions, gifts, grants, and similar amounts not included above		1f	15,042,666

g	Noncash contributions included in lines 1a - 1f:$ 975,056
h Total. Add lines 1a-1f.......		23,098,321

		Business Code
2a
b
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f ....

3 Investment income (including dividends, interest, and othersimilar amounts) ......			2,265,411			2,265,411
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........			60,143			60,143
		(ii) Personal	(i) Real
6a	Gross rents		8,098
b	Less: rental expenses		0
c	Rental income or (loss)		8,098
d	Net rental income or (loss)......			8,098			8,098
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	3,100,000	16,752,602
b	Less: cost or other basis and sales expenses	1,424,588	14,845,713
c	Gain or (loss)	1,675,412	1,906,889
d	Net gain or (loss).....			3,582,301			3,582,301
8a	Gross income from fundraising events (not including $ 267,088of contributions reported on line 1c). See Part IV, line 18 ....
	a		235,078
b	Less: direct expenses ...b		232,267
c	Net income or (loss) from fundraising events..			2,811			2,811
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a		46,245
b	Less: direct expenses ...b		272
c	Net income or (loss) from gaming activities..			45,973			45,973
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..
Business Code			Miscellaneous Revenue
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......
12	Total revenue. See Instructions......			29,063,058	0	0	5,964,737

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	7,127,115	7,127,115
2	Grants and other assistance to domestic individuals. See Part IV, line 22	131,006	131,006
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16.
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	3,517,452		869,940	2,647,512
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....
9	Other employee benefits .......	473,521		75,353	398,168
10	Payroll taxes ...........	229,512		56,660	172,852
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	64,282		9,993	54,289
c	Accounting ...........
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17	11,400			11,400
f	Investment management fees ......	143,354		143,354
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	226,079		9,965	216,114
12	Advertising and promotion ....	399,176		18	399,158
13	Office expenses .......	88,154		28,278	59,876
14	Information technology ......	25,472		4,041	21,431
15	Royalties ..
16	Occupancy ...........
17	Travel ............	38,264		12,243	26,021
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	198,871		176,268	22,603
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	1,956		1,956
23	Insurance ...
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	DONOR CULTIVATION	144,609		5,606	139,003
b	TAX EXPENSE	90,712		225	90,487
c	RECRUITMENT	67,260		67,260
d	BAD DEBTS	23,530			23,530
e	All other expenses	9,461		1,751	7,710
25	Total functional expenses. Add lines 1 through 24e	13,011,186	7,258,121	1,462,911	4,290,154
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			857,418	1	1,421,298
2	Savings and temporary cash investments .........				2
3	Pledges and grants receivable, net ......			11,555,259	3	15,994,053
4	Accounts receivable, net .............				4
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L .............
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L ..............
					6
7	Notes and loans receivable, net ....				7
8	Inventories for sale or use ........				8
9	Prepaid expenses and deferred charges ......			14,000	9	9,063
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,230,474
b	Less: accumulated depreciation	10b	323,785	2,423,974	10c	906,689
11	Investments—publicly traded securities .			83,446,000	11	89,581,221
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 ...........			11,327,579	15	10,682,126
16	Total assets. Add lines 1 through 15 (must equal line 34)...			109,624,230	16	118,594,450

17	Accounts payable and accrued expenses .....	160,730	17	229,062
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other 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 (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	1,193,037	25	686,400
26	Total liabilities. Add lines 17 through 25..	1,353,767	26	915,462

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	46,130,341	27	52,464,163
28	Temporarily restricted net assets ...........	57,636,702	28	60,442,343
29	Permanently restricted net assets	4,503,420	29	4,772,482
	Organizations that do not follow SFAS 117 (ASC 958), check here 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 ...........	108,270,463	33	117,678,988
34	Total liabilities and net assets/fund balances ........	109,624,230	34	118,594,450