Form990
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
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OMB No. 1545-0047
2019
Open to Public Inspection
A For the 2019 calendar year, or tax year beginning 07-01-2019 , and ending 06-30-2020
BCheck if applicable:
CName of organization
St John's Healthcare Foundation
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
1600 NORTH ROSE AVENUE
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
OXNARD, CA93030
D Employer identification number

20-2865781
E Telephone number

G Gross receipts $ 18,328,254
F Name and address of principal officer:
GAIL SUMMERS VP PHILANTHROPY
1600 NORTH ROSE AVENUE
OXNARD,CA93030
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.SUPPORTSTJOHNS.ORG
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 2005
M State of legal domicile: CA
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: TO PROVIDE FINANCIAL ASSISTANCE AND SUPPORT THROUGH DIGNITY HEALTH DBAS ST. JOHN'S PLEASANT VALLEY HOSPITAL AND ST. JOHN'S REGIONAL MEDICAL CENTER THROUGH PHILANTHROPY.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 24
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 23
5 Total number of individuals employed in calendar year 2019 (Part V, line 2a) ...... 5 0
6 Total number of volunteers (estimate if necessary) ............. 6 28
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 39 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 1,511,532 3,916,149
9 Program service revenue (Part VIII, line 2g) ......... 0 0
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 981,387 742,986
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 7,600 -101,330
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 2,500,519 4,557,805
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 5,030,487 2,783,693
14 Benefits paid to or for members (Part IX, column (A), line 4).....   0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 0 0
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 7,500 1,850
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet233,467    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 880,253 890,818
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 5,918,240 3,676,361
19 Revenue less expenses. Subtract line 18 from line 12....... -3,417,721 881,444
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 21,057,130 18,309,314
21 Total liabilities (Part X, line 26)............. 4,922,845 1,674,604
22 Net assets or fund balances. Subtract line 21 from line 20..... 16,134,285 16,634,710
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2019)
Form 990 (2019)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: ST. JOHN'S HEALTHCARE FOUNDATION (OXNARD AND PLEASANT VALLEY) IS A NON-PROFIT, TAX-EXEMPT ORGANIZATION THAT RAISES, MANAGES, AND DISTRIBUTES FUNDS ON BEHALF OF ST. JOHN'S REGIONAL MEDICAL CENTER AND ST. JOHN'S PLEASANT VALLEY HOSPITAL. WE BELIEVE THAT ALL PEOPLE IN OUR COMMUNITY DESERVE HIGH QUALITY HEALTHCARE SERVICES THAT ENHANCE THEIR WELL-BEING IN BODY, MIND AND SPIRIT. WE BELIEVE THAT THE SISTERS OF MERCY, THROUGH THEIR MISSION AT ST. JOHN'S REGIONAL MEDICAL CENTER AND ST. JOHN'S PLEASANT VALLEY HOSPITAL, PROVIDE THE MOST EFFECTIVE DELIVERY OF HEALTHCARE SERVICES. THE FOUNDATION SUPPORTS THE MISSION, VALUES, AND STRATEGIC PLAN OF ST. JOHN'S REGIONAL MEDICAL CENTER AND ST. JOHN'S PLEASANT VALLEY HOSPITAL BY RAISING FUNDS FOR THE HOSPITALS' BENEFIT AND BY PROMOTING THE VALUES OF THE SISTERS OF MERCY IN THE COMMUNITY.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 2,783,693 including grants of $ 2,783,693 ) (Revenue $ 0 )
THE FOUNDATION IS AN IRC SEC 509(A)(3) SUPPORTING ORGANIZATION TO DIGNITY HEALTH, DBA ST. JOHN'S REGIONAL MEDICAL CENTER AND ST. JOHN'S PLEASANT VALLEY HOSPITAL ("HOSPITALS"). AS A SUPPORTING ORGANIZATION, THE FOUNDATION OPERATES EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF, OR TO CARRY OUT THE PURPOSES OF THE HOSPITALS WHICH INCLUDE MAKING PAYMENTS DIRECTLY TO THE HOSPITALS.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet2,783,693
Form 990 (2019)
Form 990 (2019)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II.........
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part III..
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part I.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part II....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D, Part III..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IV..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D, Part VI. ...................
11a
 
No
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIII.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IX............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I(see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............ Click to see attachment
18
Yes
 
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....
20a
 
No
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
 
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
21
Yes
 
Form 990 (2019)
Form 990 (2019)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I ....
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part II...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part III.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....
28b
 
No
c
A 35% controlled entity of one or more individuals and/or organizations described in lines 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..Click to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...
35b
 
No
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2.............
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VI
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable ..
1a
0
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
 
 
Form 990 (2019)
Form 990 (2019)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
0
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
 
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
Yes
 
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
No
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see instructions and file Form 4720, Schedule N.
15
 
No
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
Form 990 (2019)
Form 990 (2019)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
24
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
23
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
 
No
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
 
No
b
Other officers or key employees of the organization ................
15b
 
No
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
CA
18
Section 6104 requires an organization to make its Form 1023 (or 1024-A if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletRandy Bradley3033 North 3rd Avenue   Phoenix,AZ85013 (602) 307-2546
Form 990 (2019)
Form 990 (2019)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

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

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

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

See instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(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
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) Dan Burrell
 
Chair
 1.0
.................
0 		X   X       0 0 0
(2) Dustin Dockter
 
Secretary
 1.0
.................
0 		X   X       0 0 0
(3) Jaye Heybl
 
Vice Chair
 1.0
.................
0 		X   X       0 0 0
(4) Katherine Edsall Wells
 
Vice Chair
 1.0
.................
0 		X   X       0 0 0
(5) Billie Jo Rodriguez
 
Board Member
 1.0
.................
0 		X           0 0 0
(6) Brooks Wise
 
Board Member
 1.0
.................
0 		X           0 0 0
(7) Darren Lee
 
Board Member
 1.0
.................
50.0 		X           0 684,643 109,173
(8) Dean Black MD
 
Board Member
 1.0
.................
0 		X           0 0 0
(9) Donald Toussaint
 
Board Member
 1.0
.................
0 		X           0 0 0
(10) Eddie Wang
 
Board Member
 1.0
.................
0 		X           0 0 0
(11) Gregory Glover
 
Board Member
 1.0
.................
0 		X           0 0 0
(12) Haimesh Shah MD
 
Board Member
 1.0
.................
0 		X           0 0 0
(13) James McPherson
 
Board Member
 1.0
.................
0 		X           0 0 0
(14) Jaysree Lad
 
Board Member
 1.0
.................
0 		X           0 0 0
(15) Jennifer Steen MD
 
Board Member
 1.0
.................
2.0 		X           0 4,425 0
(16) Jim Scanlon
 
Board Member
 1.0
.................
0 		X           0 0 0
(17) Joseph Muklevicz
 
Board Member
 1.0
.................
0 		X           0 0 0
Form 990 (2019)
Form 990 (2019)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and title 		(B)
Average hours per week (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
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) Karuna Valiveti
 
Board Member
 1.0
.......................0 		X           0 0 0
(19) Laura Viets
 
Board Member
 1.0
.......................0 		X           0 0 0
(20) Mary Anne McCabe
 
Board Member
 1.0
.......................0 		X           0 0 0
(21) Mary Fish
 
Board Member
 1.0
.......................0 		X           0 0 0
(22) Mike Foxworthy
 
Board Member
 1.0
.......................0 		X           0 0 0
(23) Nancy Schreiner
 
Board Member
 1.0
.......................0 		X           0 0 0
(24) Raj Bhatia MD FCCP
 
Board Member
 1.0
.......................0 		X           0 0 0
(25) Suzanne Fussell MD
 
Board Member
 1.0
.......................0 		X           0 0 0
(26) Tania Shapiro
 
Board Member
 1.0
.......................0 		X           0 0 0
(27) Thomas Cronley
 
Board Member
 1.0
.......................0 		X           0 0 0
(28) Walt Wood
 
Board Member
 1.0
.......................0 		X           0 0 0
(29) Charles Cova
 
Division SVP Operations & CEO
 1.0
.......................50.0 		    X       0 2,041,185 183,144
(30) Dean Shepardson
 
CFO
 1.0
.......................50.0 		    X       0 365,257 61,090
(31) Deborah Klein
 
VP of Philanthropy
 50.0
.......................0 		    X       0 319,736 30,373
(32) Deborah Nicklas
 
Interim Chief Philanthropy Officer
 25.0
.......................25.0 		    X       0 222,196 41,467
(33) Matthew D Richardson
 
Interim CFO
 1.0
.......................50.0 		    X       0 400,813 66,825
(34) Houshang S Abd
 
Former Officer
 0.0
.......................50.0 		          X 0 227,576 16,009
(35) Sue Andersen
 
Former Officer
 0.0
.......................50.0 		          X 0 740,470 120,733
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 0 5,006,301 628,814
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet0
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(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 $100,000 of compensation from the organization MediumBullet0
Form 990 (2019)
Form 990 (2019)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b 1,135
c Fundraising events..1c 166,615
d Related organizations1d 979,408
e Government grants (contributions)1e 1,681
f All other contributions, gifts, grants, and similar amounts not included above1f 2,767,310
g Noncash contributions included in lines 1a - 1f:$ 1g 443,479
h Total. Add lines 1a-1f.......MediumBullet 3,916,149
Program Service RevenueAmt Business Code
2a
b
c
d
e
f All other program service revenue. 0 0 0 0
g Total. Add lines 2a–2f .....MediumBullet 0
OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 142,632     142,632
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents     6a
b Less: rental expenses     6b
c Rental income or (loss) 0 0 6c
d Net rental income or (loss).......MediumBullet        
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory   14,219,118 7a
b Less: cost or other basis and sales expenses   13,618,764 7b
c Gain or (loss) 0 600,354 7c
d Net gain or (loss).........MediumBullet 600,354     600,354
8a Gross income from fundraising events (not including $ 166,615of contributions reported on line 1c). See Part IV, line 18 ....
8a 50,355
b Less: direct expenses ... 8b 151,685
c Net income or (loss) from fundraising events..MediumBullet -101,330   -101,330
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a  
b Less: direct expenses ... 9b  
c Net income or (loss) from gaming activities..MediumBullet        
10a Gross sales of inventory, less
returns and allowances ..
10a  
b Less: cost of goods sold .. 10b  
c Net income or (loss) from sales of inventory..MediumBullet        
Business Code Miscellaneous Revenue
11a            
b            
c            
d All other revenue .... 0 0 0 0
e Total. Add lines 11a–11d ...... MediumBullet 0
12 Total revenue. See instructions.....MediumBullet 4,557,805 0 0 641,656
Form 990 (2019)
Form 990 (2019)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 2,783,693 2,783,693
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ...........    
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 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........        
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....        
9 Other employee benefits .......        
10 Payroll taxes ...........        
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 9,810   9,810  
c Accounting ...........        
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17 1,850 1,850
f Investment management fees ...... 40,570   40,570  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 773,518 0 571,490 202,028
12 Advertising and promotion .... 19,390   10,871 8,519
13 Office expenses ....... 34,178   15,743 18,435
14 Information technology ...... 2,530     2,530
15 Royalties ..        
16 Occupancy ...........        
17 Travel ............ 5,296   5,296  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 933   933  
20 Interest ...........        
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..        
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 Food 2,041   1,972 69
b Flowers 777   751 26
c Dues and subscriptions 1,479   1,479  
d
e All other expenses 296 0 286 10
25 Total functional expenses. Add lines 1 through 24e 3,676,361 2,783,693 659,201 233,467
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 MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2019)
Form 990 (2019)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 0 1 0
2 Savings and temporary cash investments ......... 5,229,278 2 10,425,424
3 Pledges and grants receivable, net ...... 346,447 3 461,719
4 Accounts receivable, net ............. 0 4 0
5 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
0 6 0
7 Notes and loans receivable, net ........... 0 7 0
8 Inventories for sale or use ............ 0 8 0
9 Prepaid expenses and deferred charges ...... 0 9 0
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 0
b Less: accumulated depreciation 10b 0 0 10c 0
11 Investments—publicly traded securities . 7,988,606 11 3,823,274
12 Investments—other securities. See Part IV, line 11 ..... 7,396,075 12 3,588,897
13 Investments—program-related. See Part IV, line 11 .. 0 13  
14 Intangible assets ............... 0 14  
15 Other assets. See Part IV, line 11 ........... 96,724 15 10,000
16 Total assets. Add lines 1 through 15 (must equal line 33)... 21,057,130 16 18,309,314
Liabilities 17 Accounts payable and accrued expenses ..... 11,048 17 11,557
18 Grants payable ... 4,902,029 18 1,653,879
19 Deferred revenue ......... 0 19 0
20 Tax-exempt bond liabilities ......... 0 20 0
21 Escrow or custodial account liability. Complete Part IV of Schedule D 0 21 0
22 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 0 23 0
24 Unsecured notes and loans payable to unrelated third parties .. 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D 9,768 25 9,168
26 Total liabilities. Add lines 17 through 25.. 4,922,845 26 1,674,604
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 12,396,003 27 11,755,397
28 Net assets with donor restrictions ........... 3,738,282 28 4,879,313
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... 16,134,285 32 16,634,710
33 Total liabilities and net assets/fund balances ........ 21,057,130 33 18,309,314
Form 990 (2019)
Form 990 (2019)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
4,557,805
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
3,676,361
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
881,444
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
16,134,285
5
Net unrealized gains (losses) on investments ...............
5
-336,413
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-44,606
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
16,634,710
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2019)
Form 990 (2019)
Additional Data


Software ID: 19010655
Software Version: 2019v5.0
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
St John's Healthcare Foundation
 
Employer identification number

20-2865781
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.)
1
2
3
4
5
6
7
8
9
10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................1
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
(A) DIGNITY HEALTH (DBA ST JOHN'S REGIONAL MEDICAL CENTER)
  		941196203 3 Yes   2,183,952 1,249,914
(B) DIGNITY HEALTH (DBA ST JOHN'S PLEASANT VALLEY HOSPITAL)
  		941196203 3 Yes   178,655 63,839
Total
2
 2,362,607 1,313,753
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..  
6 Public support. Subtract line 5 from line 4.  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..            
11 Total support. Add lines 7 through 10  
12
12
 
13
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
14
14
 
15
15
 
16a
b
17a
b
18
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) 2019

Schedule A (Form 990 or 990-EZ) 2019
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) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (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) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (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.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
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
No
1
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.
1
Yes
 
2
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).
2
 
No
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
No
b
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.
3b
 
 
c
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.
3c
 
 
4a
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.
4a
 
No
b
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.
4b
 
 
c
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.
4c
 
 
5a
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).
5a
 
No
b
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?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
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.
6
 
No
7
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) .
7
 
No
8
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).
8
 
No
9a
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.
9a
 
No
b
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.
9b
 
No
c
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.
9c
 
No
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
 
No
b
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) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
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
 
No
b
A family member of a person described in (a) above?
11b
 
No
c
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
 
No
Section B. Type I Supporting Organizations
Yes
No
1
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.
1
Yes
 
2
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.
2
 
No
Section C. Type II Supporting Organizations
Yes
No
1
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).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
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?
1
 
 
2
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).
2
 
 
3
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.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
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.
2a
 
 
b
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.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
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.
3a
 
 
b
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.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
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  
7
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
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 2019 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-2019 		(iii)
Distributable
Amount for 2019
1 Distributable amount for 2019 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI).
See instructions.		  
3 Excess distributions carryover, if any, to 2019:
a From 2014.......  
b From 2015.......  
c From 2016.......  
d From 2017.......  
e From 2018.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2019 distributable amount  
i Carryover from 2014 not applied (see
instructions) 		 
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2019 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2019 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2019, 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 2019. 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 2020. Add lines
3j and 4c.		  
8 Breakdown of line 7:
a Excess from 2015.....  
b Excess from 2016.....  
c Excess from 2017.....  
d Excess from 2018.....  
e Excess from 2019.....  
Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019
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, Part I, Line 12g amount of support THE FOUNDATION PROVIDED OR PURCHASED FOR THE BENEFIT OF DIGNITY HEALTH DBA ST. JOHN'S REGIONAL MEDICAL CENTER AND ST. JOHN'S PLEASANT VALLEY HOSPITAL, VARIOUS SERVICES, FACILITIES AND GOODS. SEE FORM 990, PART IX FOR FURTHER DETAILS.
Schedule A (Form 990 or 990-EZ) 2019


Additional Data


Software ID: 19010655
Software Version: 2019v5.0
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Name of the organization
St John's Healthcare Foundation
 
Employer identification number

20-2865781
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ






Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution: An organization that 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) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2
Name of organization
St John's Healthcare Foundation
  		Employer identification number
20-2865781
Part I
Contributors
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
 
 
 
 
  ,    

$ RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Page 3
Name of organization
St John's Healthcare Foundation
  		Employer identification number

20-2865781
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) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Page 4
Name of organization
St John's Healthcare Foundation
  		Employer identification number

20-2865781
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 $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Additional Data


Software ID: 19010655
Software Version: 2019v5.0
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
SchDMd Bullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
St John's Healthcare Foundation
 
Employer identification number

20-2865781
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds 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? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
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.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
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.
1a
If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included on Form 990, Part VIII, line 1 .........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
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) 2019

Schedule D (Form 990) 2019
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
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):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part 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  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
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 .... 626,711 1,282,296 1,199,288 976,302 976,302
b Contributions ...       244,743  
c Net investment earnings, gains, and losses 7,758 722,813 83,008 -21,757  
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ... 		  739,199      
f Administrative expenses ....   639,199      
g End of year balance ...... 634,469 626,711 1,282,296 1,199,288 976,302
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet16 %
b
Permanent endowment SchDMd Bullet4 %
c
Term endowment SchDMd Bullet80 %
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .................
3a(i)
 
No
(ii) Related organizations .................
3a(ii)
 
No
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
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 ....        
c Leasehold improvements        
d Equipment ....        
e Other .....        
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet  
Schedule D (Form 990) 2019

Schedule D (Form 990) 2019
Page 3
Part VII
Investments—Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1) Financial derivatives.........    
(2) Closely-held equity interests........    
(3) Other
(A) POOLED INVESTMENTS		 3,588,897 F
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 3,588,897
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
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
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
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  
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 9,168
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) 2019

Schedule D (Form 990) 2019
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1.................. 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b.................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities ......... 2a  
b Prior year adjustments ............ 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d.................... 2e  
3 Subtract line 2e from line 1................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b..................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
Schedule D, Part V, Line 4 Intended uses of endowment funds ENDOWMENT FUNDS ARE USED TO SUPPORT THE HOSPITAL BUILDING PROJECTS, COMMUNITY CLINICS AND OTHER HOSPITAL PROGRAMS. THE PRINCIPAL AMOUNTS OF THE FUNDS ARE RETAINED AS BOARD SPECIFIED OR IN PERPETUITY AND THE EARNINGS ARE EXPENDED TO SUSTAIN HOSPITALS NEEDS IN ACCORDANCE WITH THE SPECIFIED INTENT.
Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote THE ORGANIZATION REVIEWS ITS TAX POSITIONS QUARTERLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS.
Schedule D (Form 990) 2019


Additional Data


Software ID: 19010655
Software Version: 2019v5.0




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 arrowAttach to Form 990 or Form 990-EZ.
right arrowGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
St John's Healthcare Foundation
 
Employer identification number

20-2865781
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.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
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?
b
If "Yes," list the 10 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) 		(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity 		(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i) 		(vi) Amount paid to
(or retained by)
organization
Yes No
             
             
             
             
             
             
             
             
             
             
Total . . . . . . . . . . . . . . . . . . . . right arrow      
3
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) 2019
Schedule G (Form 990 or 990-EZ) 2019
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.









VerticalRevenue
(a) Event #1

2019 Adventure Gala
(event type) 		(b) Event #2

Golf 2020
(event type) 		(c) Other events

 
(total number) 		(d) Total events
(add col. (a) through col. (c))

1
Gross receipts . . . . .
216,220
750
 
216,970

2
Less: Contributions . . . .
165,890
725
 
166,615
3 Gross income (line 1 minus
line 2) . . . . . .
50,330
25
0
50,355



VerticalDirectExpenses
4 Cash prizes . . . . . 0 0   0
5 Noncash prizes . . . . 20,419 0   20,419
6 Rent/facility costs . . . . 0 0   0
7 Food and beverages . . . 74,106 0   74,106
8 Entertainment . . . . 6,050 0   6,050
9 Other direct expenses . . . 49,678 1,432   51,110
10 Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . . right arrow 151,685
11 Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . . right arrow -101,330
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.
VerticalRevenue
(a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo 		(c) Other gaming (d) Total gaming (add col.(a) through col.(c))

1
Gross revenue . . . . .
 
 
 
 
VerticalDirectExpenses

2
Cash prizes . . . . .
 
 
 
 

3
Noncash prizes . . . .
 
 
 
 

4
Rent/facility costs . . . .
 
 
 
 

5
Other direct expenses . . .
 
 
 
 


6

Volunteer labor . . . .
%
%
%


7
Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow
 

8
Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow
 

9
Enter the state(s) in which the organization conducts gaming activities:
a
Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .
b
If "No," explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .
b
If "Yes," explain:
 
Schedule G (Form 990 or 990-EZ) 2019
Schedule G (Form 990 or 990-EZ) 2019
Page 3
11
Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .
12
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? . . . . . . . . . . . . . . . . .
13
Indicate the percentage of gaming activity conducted in:
a
The organization's facility . . . . . . . . . . . . . . . . . .
13a
%
b
An outside facility . . . . . . . . . . . . . . . . . . . .
13b
%
14
Enter the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? . . . . . . . . . . . . . . . . . . . . . . . .
b
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 $   .
c
If "Yes," enter name and address of the third party:
Name right arrow
Address right arrow
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? . . . . . . . . . . . . . . . . . . .
b
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) 2019
Additional Data


Software ID: 19010655
Software Version: 2019v5.0

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
2019
Open to Public
Inspection
Name of the organization
St John's Healthcare Foundation
 
Employer identification number
20-2865781
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to 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 (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
noncash assistance		 (h) Purpose of grant
or assistance
(1) Dignity Health dba St John's Regional Medical Center
1600 North Rose Avenue
Oxnard,CA93030 		94-1196203 501(c)(3) 2,183,952 357,247 FMV med supplies/equipment/bibles/toys/food HOSPITAL SUPPORT
(2) Dignity Health dba St John's Pleasant Valley Hospital
2309 Antonio Avenue
Camarillo,CA93010 		94-1196203 501(c)(3) 178,655 63,839 FMV med supplies HOSPITAL SUPPORT
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
1
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2019

Schedule I (Form 990) 2019
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients		 (c) Amount of
cash grant		 (d) Amount of
noncash assistance		 (e) Method of valuation (book,
FMV, appraisal, other)		 (f) Description of noncash assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. AS A SEC. 509(A)(3) SUPPORTING ORGANIZATION, THE FOUNDATION OPERATES EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF, OR TO CARRY OUT THE PURPOSES OF THE GRANTEES LISTED IN PART II, ITEMS 1 AND 2(DIGNITY HEALTH DBA'S ST. JOHN'S REGIONAL MEDICAL CENTER AND ST. JOHN'S PLEASANT VALLEY HOSPITAL), WHICH INCLUDES MAKING PAYMENTS DIRECTLY TO THE BENEFICIARY ORGANIZATION, TRANSFERRING AND MONITORING THAT RESTRICTIONS ARE MET BEFORE RELEASE OF FUNDS AND EXPENDITURE OF SUCH FUNDS.
Schedule I (Form 990) 2019



Additional Data


Software ID: 19010655
Software Version: 2019v5.0


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
2019
Open to Public Inspection
Name of the organization
St John's Healthcare Foundation
 
Employer identification number

20-2865781
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ..
2
 
 
3
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.
4
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:
a
Receive a severance payment or change-of-control payment? .............
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
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:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
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:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
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 ............
7
 
No
8
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 ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2019

Schedule J (Form 990) 2019
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
(i) Base
compensation 		(ii) Bonus & incentive
compensation 		(iii) Other reportable compensation
1Darren Lee
 
Board Member 		(i)

(ii)		 0
-------------
469,737 		0
-------------
185,150 		0
-------------
29,756 		0
-------------
66,580 		0
-------------
42,593 		0
-------------
793,816 		0
-------------
0
2Houshang S Abd
 
Former Officer 		(i)

(ii)		 0
-------------
72,918 		0
-------------
0 		0
-------------
154,658 		0
-------------
9,674 		0
-------------
6,335 		0
-------------
243,584 		0
-------------
0
3Sue Andersen
 
Former Officer 		(i)

(ii)		 0
-------------
419,806 		0
-------------
287,754 		0
-------------
32,911 		0
-------------
71,056 		0
-------------
49,677 		0
-------------
861,204 		0
-------------
0
4Charles Cova
 
Division SVP Operations & CEO 		(i)

(ii)		 0
-------------
623,038 		0
-------------
846,816 		0
-------------
571,331 		0
-------------
138,431 		0
-------------
44,713 		0
-------------
2,224,329 		0
-------------
534,953
5Deborah Klein
 
VP of Philanthropy 		(i)

(ii)		 0
-------------
174,438 		0
-------------
500 		0
-------------
144,798 		0
-------------
21,714 		0
-------------
8,658 		0
-------------
350,109 		0
-------------
0
6Deborah Nicklas
 
Interim Chief Philanthropy Officer 		(i)

(ii)		 0
-------------
158,371 		0
-------------
62,993 		0
-------------
831 		0
-------------
26,400 		0
-------------
15,067 		0
-------------
263,662 		0
-------------
0
7Matthew D Richardson
 
Interim CFO 		(i)

(ii)		 0
-------------
299,689 		0
-------------
100,823 		0
-------------
301 		0
-------------
43,837 		0
-------------
22,988 		0
-------------
467,639 		0
-------------
0
8Dean Shepardson
 
CFO 		(i)

(ii)		 0
-------------
234,320 		0
-------------
109,683 		0
-------------
21,254 		0
-------------
38,761 		0
-------------
22,329 		0
-------------
426,347 		0
-------------
0
Schedule J (Form 990) 2019

Schedule J (Form 990) 2019
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
Schedule J, Part III SUPPLEMENTAL DISCLOSURES THE ORGANIZATION DOES NOT DIRECTLY EMPLOY ANY PERSONNEL, HOWEVER, THE SUPPORTED ORGANIZATION'S EXECUTIVE COMPENSATION PHILOSOPHY IS DESIGNED TO ASSIST THE ORGANIZATION IN ATTRACTING AND RETAINING THE CALIBER OF EXECUTIVES REQUIRED TO ENABLE TO FULFILL ITS MISSION OF PROVIDING HIGH QUALITY HEALTHCARE FOR ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES, IMPROVING THE QUALITY OF LIFE IN THE COMMUNITIES IT SERVES, PROMOTING PATIENT AND EMPLOYEE SATISFACTION, AND ENSURING FINANCIAL STABILITY. A SUBSTANTIAL PORTION OF EXECUTIVE COMPENSATION IS PERFORMANCE BASED AND IS LINKED TO ORGANIZATIONAL GOALS APPROVED IN ADVANCE BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE. THESE GOALS INCLUDE ATTAINMENT OF ANNUAL AND LONG-TERM FINANCIAL PERFORMANCE, CERTAIN HEALTHCARE QUALITY STANDARDS AND DIGNITY HEALTH'S COMMITMENT TO SERVING THE POOR AND DISENFRANCHISED IN THE COMMUNITIES IT SERVES. TOTAL COMPENSATION, WHICH INCLUDES BASE SALARY, ANNUAL AND LONG-TERM INCENTIVE COMPENSATION, IS ESTABLISHED TO APPROXIMATE THE PREVAILING MARKET CONDITIONS FOR EXECUTIVES OF COMPANIES OF SIMILAR SIZE, REVENUES AND COMPLEXITY. PAYMENTS PURSUANT TO A LONG-TERM FINANCIAL PERFORMANCE GOAL WERE PAID IN CALENDAR YEAR 2019.
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation THE ORGANIZATION RELIED ON A RELATED ORGANIZATION, DIGNITY HEALTH, THAT USED ONE OR MORE OF THE METHODS DESCRIBED IN SCHEDULE J, PART I, LINE 3, TO ESTABLISH THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL'S COMPENSATION. SEE SCHEDULE O DISCLOSURE FOR FORM 990, PART VI, SECTION B, LINE 15 FOR ADDITIONAL INFORMATION.
Schedule J, Part I, Line 4a Severance or change-of-control payment CERTAIN LISTED PERSONS PARTICIPATE IN A DIGNITY HEALTH SEVERANCE PLAN THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 2 WEEKS TO 2 YEARS OF BASE COMPENSATION, DEPENDING ON THE EXECUTIVE'S POSITION, IN THE EVENT OF POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE PLAN. PAYMENTS OCCURED DURING 2019 PURSUANT TO THE PLAN ARRANGEMENT INCLUDE D. KLEIN, $114,141 AND H. ABD, $147,897.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan CERTAIN LISTED PERSONS PARTICIPATE IN THE DIGNITY HEALTH EXCESS BENEFIT PLAN, A NONQUALIFIED SUPPLEMENTAL BENEFIT PLAN LIMITED TO PARTICIPANTS IN THE DIGNITY HEALTH RETIREMENT PLAN WHOSE BENEFITS ARE AFFECTED BY THE LIMITATIONS IMPOSED BY SECTIONS 401(A)(17) AND 415 OF THE INTERNAL REVENUE CODE. BENEFIT SERVICE UNDER THIS PLAN WAS FROZEN AS OF JANUARY 1, 2008. NO PAYMENTS OCCURED DURING 2019 PURSUANT TO THE PLAN ARRANGEMENT. CERTAIN LISTED PERSONS ARE ELIGIBLE TO PARTICIPATE IN NON-QUALIFIED 457(F) PLANS THAT ARE SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE, AS REQUIRED BY THE IRS. THE 2007 EXECUTIVE DEFERRED COMPENSATION PLAN IS FOR EXECUTIVES HIRED PRIOR TO JUNE 30, 2006. THE BENEFIT IS INTENDED TO BRIDGE THE DIFFERENCE, IF ANY, BETWEEN THE BENEFIT PROVIDED UNDER THE DIGNITY HEALTH EXCESS BENEFIT PLAN HAD BENEFIT SERVICE NOT BEEN FROZEN AT JANUARY 1, 2008, AND THE BENEFITS PROVIDED FROM ALL OTHER QUALIFIED AND NON-QUALIFIED PLANS. BENEFITS VEST UNDER THIS 457(F) PLAN AT THE LATER OF THE DATE THE PARTICIPANT ATTAINS AGE 62 OR IS CREDITED WITH 15 YEARS OF SERVICE. THE 2010 EXECUTIVE DEFERRED COMPENSATION PLAN IS FOR CERTAIN OFFICERS AND KEY EMPLOYEES, PRIMARILY THOSE WHO ARE NOT ELIGIBLE TO PARTICIPATE IN THE DIGNITY HEALTH EXCESS BENEFIT PLAN OR THE 2007 EXECUTIVE DEFERRED COMPENSATION PLAN DESCRIBED ABOVE. THIS BENEFIT PROVIDES AN ANNUAL ACCRUAL OF 10% OF TOTAL COMPENSATION AND IS PAYABLE ANNUALLY ON JULY 1 ONCE VESTED, WHICH IS AGE 62 WITH 5 YEARS OF SERVICE; THE PLAN ALSO ALLOWS FOR SPECIAL AWARDS. PAYMENTS MADE UNDER THIS PLAN DURING 2019 INCLUDE C. COVA; $534,953. COMPENSATION AMOUNTS FOR THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS DISCUSSED ABOVE ARE REPORTED AS DEFERRED COMPENSATION IN THE YEAR ACCRUED (SCHEDULE J, PART II, COLUMN C) AND ARE REFLECTED AGAIN AS REPORTABLE COMPENSATION IN THE YEAR PAID (SCHEDULE J, PART II, COLUMN B(III)).
Schedule J (Form 990) 2019

Additional Data


Software ID: 19010655
Software Version: 2019v5.0
SCHEDULE M
(Form 990)

Department of the Treasury
Internal Revenue Service
Noncash Contributions
Right pointing arrow large imageComplete 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 imageGo to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
St John's Healthcare Foundation
 
Employer identification number

20-2865781
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 .. X 175 Other
5 Clothing and household
goods ....... 		X 12,485 Other
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded . X 2 5,754 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 ..        
17 Real estate—Other ...        
18 Collectibles .....        
19 Food inventory ...        
20 Drugs and medical supplies . X 7,228 63,575 Other - Comparable sale
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( Gift Certificates/Tickets (Entertainment) ) X 69 5,712 Other - Comparable sale
26 Other Right pointing arrow large image ( Food and Wine ) X 8,650 190,430 Other - Comparable sale
27 Other Right pointing arrow large image ( Medical Equipment ) X 7 150,660 Other - Comparable sale
28 Other Right pointing arrow large image ( Toys ) X 1 200 Other - Comparable sale
Other Right pointing arrow large image ( 100 5" orchids with pots ) X 1 1,950 Other - Comparable sale
Other Right pointing arrow large image ( 1,500 potted orchids ) X 1 7,500 Other - Comparable sale
Other Right pointing arrow large image ( Visit Oxnard Package - Wine Tasting ) X 1 983 Other - Comparable sale
Other Right pointing arrow large image ( Event Decorations ) X 1 355 Other - Comparable sale
Other Right pointing arrow large image ( Italy timeshare ) X 1 1,600 Other - Comparable sale
Other Right pointing arrow large image ( 2 Night Hotel Stay - Ritz Carlton ) X 1 2,100 Other - Comparable sale
29
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
29
0
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which isn't required to be used for exempt purposes for the entire holding period? ...................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash
contributions? ..........................
32a
 
No
b
If "Yes," describe in Part II.
33
If the organization didn't report an amount in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) (2019)
Schedule M (Form 990) (2019)
Page 2
Part IISupplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.
Return Reference Explanation
Schedule M, Part I Explanations of reporting method for number of contributions Securities - Publicly traded - THE FOUNDATION IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED Drugs and medical supplies - THE FOUNDATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. Other - Gift Certificates/Tickets (Entertainment) GIFT CERT/TICKETS: THE FOUNDATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. Other - Food and Wine THE FOUNDATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. Other - Medical Equipment THE FOUNDATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. Other - Toys THE FOUNDATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. Other - 100 5" orchids with pots THE FOUNDATION IS REPORTING THE NUMBER OF CONTRIBUTIONS. Other - 1,500 potted orchids THE FOUNDATION IS REPORTING THE NUMBER OF CONTRIBUTIONS. Other - Visit Oxnard Package - Wine Tasting THE FOUNDATION IS REPORTING THE NUMBER OF CONTRIBUTIONS. Other - Event Decorations THE FOUNDATION IS REPORTING THE NUMBER OF CONTRIBUTIONS. Other - Italy timeshare THE FOUNDATION IS REPORTING THE NUMBER OF CONTRIBUTIONS. Other - 2 Night Hotel Stay - Ritz Carlton THE FOUNDATION IS REPORTING THE NUMBER OF CONTRIBUTIONS.
Schedule M (Form 990) (2019)

Additional Data


Software ID: 19010655
Software Version: 2019v5.0
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
2019
Open to Public
Inspection
Name of the organization
St John's Healthcare Foundation
 
Employer identification number

20-2865781
Return Reference Explanation
Form 990, Part V, Line 2a number of employees THE ORGANIZATION DOES NOT HAVE EMPLOYEES. AS A SUPPORTING ORGANIZATION, THE FOUNDATION OPERATES FOR THE BENEFIT OF THE HOSPITAL AND UTILIZES THE EMPLOYEES OF THAT HOSPITAL. THE PROPORTIONATE SALARIES AND BENEFITS FOR THESE INDIVIDUALS ARE ALLOCATED TO THE FOUNDATION. THE SALARIES OF THESE EMPLOYEES ARE INCLUDED IN THE HOSPITAL ENTITY'S FORM W 3 AND FEDERAL EMPLOYMENT TAX RETURNS.
Form 990, Part VI, Line 15 process to determine compensation FOR THE 2019 COMPENSATION, THE SUPPORTED ORGANIZATION'S HUMAN RESOURCES DEPARTMENT OBTAINED A MARKET STUDY FOR THE TOP MANAGEMENT OFFICIAL'S COMPENSATION THAT DETAILS A RANGE OF SALARY. THE HUMAN RESOURCES AND COMPENSATION COMMITTEE APPROVES, CONSISTENT WITH THE ORGANIZATION'S PHILOSOPHY AND PRINCIPLES, THE ANNUAL PERFORMANCE GOALS AND CRITERIA TO BE USED IN DETERMINING MERIT INCREASES AND VARIABLE COMPENSATION CRITERIA FOR OFFICERS AND EXECUTIVES. THE HUMAN RESOURCES AND COMPENSATION COMMITTEE ALSO ENGAGES OUTSIDE LEGAL COUNSEL AS NECESSARY AND QUALIFIED INDEPENDENT COMPENSATION AND BENEFITS SPECIALISTS (INDEPENDENT EXPERTS) TO REVIEW, ANALYZE AND PROVIDE BENCHMARKING DATA FOR THE TOTAL COMPENSATION AND BENEFITS PACKAGES OF OFFICERS AND KEY EXECUTIVES. APPROPRIATE COMPARABLE DATA IS OBTAINED FROM THE INDEPENDENT EXPERTS, (E.G., TOTAL ECONOMIC BENEFITS PAID BY SIMILARLY SITUATED ORGANIZATIONS, BOTH TAXABLE AND TAX-EXEMPT, FOR SIMILAR JOB RESPONSIBILITIES). KEY DELIBERATIONS OF THE COMMITTEE ARE DOCUMENTED IN MEETING MINUTES WHICH ARE APPROVED AT THE NEXT COMMITTEE MEETING AND PROVIDED TO THE BOARD OF DIRECTORS. THE DOCUMENTATION OF THE DELIBERATIONS INCLUDES (A) THE TERMS OF THE AGREEMENT APPROVED AND THE DATE APPROVED; (B) THE MEMBERS OF THE COMMITTEE WHO WERE PRESENT DURING DISCUSSION OF THE APPROVED AGREEMENT AND THOSE WHO VOTED ON IT; AND (C) THE COMPARABILITY DATA OBTAINED AND RELIED UPON BY THE COMMITTEE AND HOW THE DATA WAS OBTAINED.
Form 990, Part VI, Line 2 Family/business relationships amongst interested persons B. J. RODRIGUEZ, T. SHAPIRO - Business relationship
Form 990, Part VI, Line 6 Classes of members or stockholders THE ORGANIZATION HAS A SOLE CORPORATE MEMBER, DIGNITY HEALTH, A 501(C)(3) EXEMPT ORGANIZATION. ON FEBRUARY 1, 2019, DIGNITY HEALTH AND CATHOLIC HEALTH INITIATIVES ("CHI"), A COLORADO NONPROFIT CORPORATION, EFFECTED A BUSINESS COMBINATION. ON THAT DATE, CHI CHANGED ITS NAME TO COMMONSPIRIT HEALTH AND BECAME THE SOLE CORPORATE MEMBER OF DIGNITY HEALTH. COMMONSPIRIT HEALTH IS A CATHOLIC HEALTHCARE SYSTEM SPONSORED BY THE PUBLIC JURIDIC PERSON, CATHOLIC HEALTH CARE FEDERATION ("CHCF").
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body DIGNITY HEALTH, AS THE SOLE CORPORATE MEMBER, RATIFIES THE SELECTION OF MEMBERS AND THE DIGNITY HEALTH BOARD APPROVES NEW BOARD MEMBERS, MAY APPOINT AND REMOVE ANY BOARD MEMBERS OF THE FOUNDATION.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders RESERVED RIGHTS OF THE CORPORATE MEMBER INCLUDE ADOPTION OF MISSION AND PHILOSOPHY STATEMENTS, AMENDMENT OR RESTATEMENT OF ARTICLES OF INCORPORATION AND BYLAWS, DISSOLUTION OF THE CORPORATION, ACQUISITION OF ANOTHER CORPORATION, CREATION OF A NEW SUBSIDIARY, MERGER OR CONSOLIDATION WITH ANOTHER CORPORATION, PARTICIPATION AS A GENERAL OR LIMITED PARTNER IN ANY VENTURE, INCURRING LONG-TERM INDEBTEDNESS IN EXCESS OF NORMAL OPERATING REQUIREMENTS, RATIFICATION OF BOARD MEMBER APPOINTMENTS AND DISMISSALS, SELECTION AND REMOVAL OF INDEPENDENT AUDITORS, AND TRANSACTIONS OUTSIDE THE ORDINARY COURSE OF BUSINESS.
Form 990, Part VI, Line 11b Review of form 990 by governing body THE SUPPORTED ORGANIZATION'S CFO AND CONTROLLER REVIEWED THE RETURN AND WORKED CLOSELY WITH COMMONSPIRIT HEALTH'S TAX DEPARTMENT. THE BOARD WAS INFORMED THAT A COPY OF THE FORM 990 IS AVAILABLE FOR REVIEW AT ANY TIME DURING BUSINESS HOURS AND WILL BE A PUBLICLY REPORTED DOCUMENT.
Form 990, Part VI, Line 12c Conflict of interest policy THE FOUNDATION HAS ADOPTED DIGNITY HEALTH'S CONFLICTS OF INTEREST POLICY. DURING THE PERIOD JULY 1, 2019 - JUNE 30, 2020, DIGNITY HEALTH WAS SUBJECT TO WRITTEN CONFLICT OF INTEREST POLICIES (THE "COI POLICIES."). THESE POLICIES, PROVIDE FOR THE DISCLOSURE AND SUBSEQUENT REVIEW AND MANAGEMENT OF CONFLICTS OF INTEREST THAT MAY EXIST FOR MEMBERS OF DIGNITY HEALTH'S GOVERNING BODIES, INCLUDING ITS BOARD OF DIRECTORS AND BOARD COMMITTEES, AS WELL AS DIGNITY HEALTH'S OFFICERS AND EXECUTIVE LEADERS, KEY EMPLOYEES, MANAGEMENT PERSONNEL AT THE VICE PRESIDENT LEVEL AND ABOVE, AND ANY OTHER DESIGNATED PERSONNEL ("COVERED PERSONS"). ALL COVERED PERSONS ARE REQUIRED TO DISCLOSE ACTUAL OR POTENTIAL CONFLICTS ARISING FROM THE BUSINESS, OWNERSHIP, FINANCIAL AND PERSONAL INTERESTS HELD BY SUCH COVERED PERSONS OR THEIR FAMILY MEMBERS. COVERED PERSONS ARE REQUIRED TO DISCLOSE TO THEIR SUPERVISORS OR RELEVANT DECISION MAKERS ANY INTEREST THAT MAY PRESENT A CONFLICT OF INTEREST, OR THE APPEARANCE OF A CONFLICT OF INTEREST. SUCH DISCLOSURE IS REQUIRED ON A TRANSACTIONAL BASIS AT THE TIME SUCH CONFLICTS ARISE, WHEN AN INDIVIDUAL BECOMES A COVERED PERSON (E.G. UPON HIRING OR UPON PROMOTION), AND ANNUALLY THEREAFTER. AS PART OF THE ANNUAL DISCLOSURE SURVEY CONDUCTED PURSUANT TO THE COI POLICIES, EACH COVERED PERSON IS REQUIRED TO CERTIFY THAT HE/SHE: (1) HAS RECEIVED A COPY OF THE COI POLICY OR COI POLICIES APPLICABLE TO HIS/HER POSITION; (2) HAS READ THE COI POLICY AND UNDERSTANDS SAID POLICY; AND (3) AGREES TO COMPLY WITH ALL REQUIREMENTS OF THE COI POLICY, INCLUDING COMPLETING THE CONFLICTS OF INTEREST DISCLOSURE SURVEY AS REQUIRED BY THE COI POLICIES. THE INFORMATION FROM THE ANNUAL DISCLOSURE SURVEY IS USED TO MONITOR AND MANAGE DISCLOSED CONFLICTS OF INTEREST AND ASSURE DECISIONS ARE MADE IN THE ORGANIZATION'S BEST INTERESTS. THE PROCEDURES FOR ADDRESSING A CONFLICT OF INTEREST RELATED TO A PROPOSED TRANSACTION IN THE CASE OF GOVERNING BODIES REQUIRE THAT THE BOARD SHALL CAREFULLY SCRUTINIZE AND MUST IN GOOD FAITH EITHER APPROVE OR DISAPPROVE ANY TRANSACTION IN WHICH DIGNITY HEALTH OR A DIGNITY HEALTH ENTITY IS A PARTY AND IN WHICH THE DIRECTOR EITHER: HAS A MATERIAL FINANCIAL INTEREST OR IS A DIRECTOR OR CORPORATE OFFICER OF THE OTHER PARTY (OTHER THAN A DIGNITY HEALTH-AFFILIATED ORGANIZATION). THE BOARD MUST APPROVE THE TRANSACTION BY MAJORITY OF THE DIRECTORS ON THE BOARD, WITHOUT COUNTING THE VOTE OF ANY INDIVIDUAL WHO HAS AN INTEREST IN THE TRANSACTION. IN REVIEWING SUCH TRANSACTIONS BETWEEN DIGNITY HEALTH OR DIGNITY HEALTH ENTITIES AND VENDORS OR OTHER CONTRACTORS WHO ARE, OR ARE AFFILIATED WITH, DIRECTORS, THE BOARD SHALL ACT NO MORE OR LESS FAVORABLY THAN IT WOULD IN REVIEWING TRANSACTIONS WITH UNRELATED THIRD PARTIES. THE TRANSACTION WILL NOT BE APPROVED UNLESS THE BOARD DETERMINES THAT THE TRANSACTION IS FAIR TO DIGNITY HEALTH OR THE DIGNITY HEALTH ENTITY.
Form 990, Part VI, Line 19 Required documents available to the public FEDERAL TAX LAWS DO NOT MANDATE THAT THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS BE MADE AVAILABLE FOR PUBLIC INSPECTION. THE ORGANIZATION IS INCLUDED IN COMMONSPIRITS HEALTHS' CONSOLIDATED FINANCIAL STATEMENTS WHICH ARE AVAILABLE ON BOTH COMMONSPIRIT HEALTH'S AND DIGNITY HEALTH'S WEBSITES AND UPON REQUEST.
Form 990, Part VII, Section A compensation THE FOUNDATION DOES NOT COMPENSATE BOARD MEMBERS. BOARD MEMBERS D LEE, J STEEN ARE COMPENSATED AS EMPLOYEES OF THE SUPPORTED ORGANIZATION. CURRENT AND FORMER OFFICERS C. COVA, D. KLEIN, D. NICKLAS, M. RICHARDSON, D. SHEPARDSON, H ABD AND S ANDERSEN ARE COMPENSATED AS EMPLOYEES OF THE SUPPORTED ORGANIZATION.
Form 990, Part IX, Line 11g Other Fees Admin Services - Total Expense: 757933, Program Service Expense: , Management and General Expenses: 559976, Fundraising Expenses: 197957; Graphic/print design - Total Expense: 10038, Program Service Expense: , Management and General Expenses: 7416, Fundraising Expenses: 2622; Prof fees - Total Expense: 234, Program Service Expense: , Management and General Expenses: 173, Fundraising Expenses: 61; Other Purchased Services - Total Expense: 5313, Program Service Expense: , Management and General Expenses: 3925, Fundraising Expenses: 1388;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances Adjustment of PY pledge allowances/bad debt - -57290; CHANGE VALUE OF SPLIT AGREEMENT - 12684;
Form 990, Part XII, Line 2c OVERSIGHT OR SELECTION PROCESS THE ORGANIZATION DID NOT CHANGE ITS OVERSIGHT OR SELECTION PROCESS DURING THE TAX YEAR.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2019


Additional Data


Software ID: 19010655
Software Version: 2019v5.0
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
St John's Healthcare Foundation
 
Employer identification number

20-2865781
Part I
Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity










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


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No
(1)ALEGENT CREIGHTON CLINIC
12809 W DODGE RD

OMAHA,NE68154
47-0765154 		HOSPITAL NE 501(c)(3) 3 ACH
 
 
No
(2)ALEGENT CREIGHTON HEALTH
12809 W DODGE RD

OMAHA,NE68154
47-0757164 		HOSPITAL NE 501(c)(3) 3 CHI NEBRASKA
 
 
No
(3)ALEGENT HEALTH - BERGAN MERCY HEALTH SYSTEM
7500 MERCY RD

OMAHA,NE68124
47-0484764 		HOSPITAL NE 501(c)(3) 3 CHI NEBRASKA
 
 
No
(4)ALEGENT HEALTH - IMMANUEL MEDICAL CENTER
6901 N 72ND ST

OMAHA,NE68122
47-0376615 		HOSPITAL NE 501(c)(3) 3 CHI NEBRASKA
 
 
No
(5)ALEGENT HEALTH - MEMORIAL HOSPITAL SCHUYLER
104 W 17TH ST

SCHUYLER,NE68661
47-0399853 		HOSPITAL NE 501(c)(3) 3 CHI NEBRASKA
 
 
No
(6)ALEGENT HEALTH - MERCY HOSPITAL CORNING IOWA
PO BOX 368

CORNING,IA50841
42-0782518 		HOSPITAL IA 501(c)(3) 3 CHI NEBRASKA
 
 
No
(7)ALEGENT HEALTH-COMMUNITY MEMORIAL HOSP OF MISSOURI VALLEY IA
631 N 8TH ST

MISSOURI VALLEY,IA51555
42-0776568 		HOSPITAL IA 501(c)(3) 3 CHI NEBRASKA
 
 
No
(8)ALVERNA APARTMENTS
300 SE 8TH AVE

LITTLE FALLS,MN56345
41-1351177 		Long-TERM CARE MN 501(c)(3) 10 CSH
 
 
No
(9)APPLETREE COURT
601 OAK ST

BRECKENRIDGE,MN56520
41-1850500 		SENIOR LIVING MN 501(c)(3) 10 SFH
 
 
No
(10)Arroyo Grande Community Hospital Foundation
345 S Halcyon Rd

Arroyo Grande,CA93420
20-3256066 		FUNDRAISING FOUNDATION CA 501(c)(3) Type I Dignity Health
 
 
No
(11)Bakersfield Memorial Hospital
420 34TH Street

Bakersfield,CA93301
95-1802779 		HOSPITAL CA 501(c)(3) 3 Dignity Community Care
 
 
No
(12)Barrow Foundation UK
13 CHURCH STREET
Nunney,ENGLANDBA114LW
UK
31-1724184 		Fundraising Foundation   501(c)(3) Type III-O NA
 
 
No
(13)Barrow Neurological Foundation
350 West Thomas Road

Phoenix,AZ85013
86-0174371 		Fundraising Foundation AZ 501(c)(3) 7 Dignity Health
 
 
No
(14)BAYLOR ST LUKE'S HEALTH VENTURES
17200 ST LUKES WAY STE 170

THE WOODLANDS,TX77384
27-4499340 		PHYSICIANS TX 501(c)(3) Type I SLCHS
 
 
No
(15)BAYLOR ST LUKE'S MEDICAL GROUP
6624 FANNIN ST STE 1100

HOUSTON,TX77030
76-0458535 		PHYSICIANS TX 501(c)(3) 3 SLHS
 
 
No
(16)BORNEMANN HEALTHCARE CORPORATION
198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
23-2187242 		HEALTHCARE PA 501(c)(3) Type I CSH
 
 
No
(17)BRAZOSPORT HEALTH FOUNDATION INC
1 West Way Ct

LAKE JACKSON,TX77566
76-0080110 		FUNDRAISING FOUNDATION TX 501(c)(3) Type I BRHS
 
 
No
(18)BRAZOSPORT REGIONAL PHYSICIAN SERVICES
100 MEDICAL DRIVE

LAKE JACKSON,TX77566
80-0240261 		PHYSICIANS TX 501(c)(3) 3 BRHS
 
 
No
(19)BURLESON ST JOSEPH HEALTH CENTER
2801 FRANCISCAN DRIVE

BRYAN,TX77802
74-2759890 		HOSPITAL TX 501(c)(3) 3 SJSC
 
 
No
(20)BURLESON ST JOSEPH MANOR
2801 FRANCISCAN DRIVE

BRYAN,TX77802
74-2913931 		HEALTHCARE TX 501(c)(3) 10 SJSC
 
 
No
(21)California Hospital Medical Center Foundation
1401 South Grand Avenue

Los Angeles,CA90015
95-4000909 		FUNDRAISING FOUNDATION CA 501(c)(3) Type I Dignity Community Care
 
 
No
(22)CARRINGTON HEALTH CENTER
800 N 4TH ST

CARRINGTON,ND58421
45-0227311 		HOSPITAL ND 501(c)(3) 3 CSH
 
 
No
(23)CATHOLIC HEALTH INITIATIVES - COLORADO
9100 East Mineral Circle

Centennial,CO80112
84-0405257 		HOSPITAL CO 501(c)(3) 3 CSH
 
 
No
(24)CATHOLIC HEALTH INITIATIVES - IOWA CORP
1111 6TH AVE

DES MOINES,IA50314
42-0680448 		HOSPITAL IA 501(c)(3) 3 CSH
 
 
No
(25)CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION
1150 Kelly Johnson Blvd 204

COLORADO SPRINGS,CO80920
84-0902211 		FUNDRAISING FOUNDATION CO 501(c)(3) 7 CHIC
 
 
No
(26)CATHOLIC HEALTH INITIATIVES NATIONAL FOUNDATION
1150 Kelly Johnson Blvd 204

COLORADO SPRINGS,CO80920
27-0930004 		HEALTHCARE CO 501(c)(3) Type I CSH
 
 
No
(27)CATHOLIC HEALTH INITIATIVES VIRTUAL HEALTH SERVICES
198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
46-0992796 		PHYSICIANS CO 501(c)(3) Type I CHINS
 
 
No
(28)CENTENNIAL MEDICAL GROUP INC
2700 STEWART PKWY

ROSEBURG,OR97471
26-3946191 		SURGERY CENTER OR 501(c)(3) 10 MMC
 
 
No
(29)CENTRAL CALIFORNIA HEALTH CENTERS
300 OLD RIVER ROAD STE 200

BAKERSFIELD,CA93311
84-4171789 		CLINIC CA 501(c)(3) 3 Dignity Community Care
 
 
No
(30)CENTRAL KANSAS MEDICAL CENTER
3515 BROADWAY

GREAT BEND,KS67530
48-0543724 		HOSPITAL KS 501(c)(3) 3 CSH
 
 
No
(31)CHI HEALTH CONNECT AT HOME - FARGO
4816 AMBER VALLEY PKWY S

FARGO,ND58104
27-1966847 		HOME HEALTH MN 501(c)(3) 10 CSH
 
 
No
(32)CHI HEALTH FOUNDATION
12809 W DODGE RD

OMAHA,NE68154
47-0648586 		FUNDRAISING FOUNDATION NE 501(c)(3) 7 ACH
 
 
No
(33)CHI KENTUCKY INC
3900 OLYMPIC BLVD STE 400

ERLANGER,KY41018
20-2741651 		INVESTMENTS KY 501(c)(3) Type I CSH
 
 
No
(34)CHI LIVING COMMUNITIES
5942 RENAISSANCE PLACE STE A

TOLEDO,OH43623
34-1892096 		SENIOR LIVING OH 501(c)(3) Type I SFH
 
 
No
(35)CHI Memorial Hospital - Georgia
100 GROSS CRESCENT CIRCLE

FORT OGLETHORPE,GA30742
82-2748395 		HOSPITAL GA 501(c)(3) 3 MHCS
 
 
No
(36)CHI NATIONAL HOME CARE
198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
45-1261716 		HEALTHCARE CO 501(c)(3) 10 CHI NS
 
 
No
(37)CHI NATIONAL SERVICES
198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
45-2532084 		HEALTHCARE CO 501(c)(3) Type I CSH
 
 
No
(38)CHI NEBRASKA
12809 West Dodge Road

Omaha,NE68510
36-3233121 		HEALTHCARE NE 501(c)(3) Type I CSH
 
 
No
(39)CHI ST JOSEPH CHILDREN'S HEALTH
1929 LINCOLN HWY E STE 150

LANCASTER,PA17602
23-2342997 		HEALTHCARE PA 501(c)(3) Type I CSH
 
 
No
(40)CHI ST JOSEPH'S CHILDREN
1516 5TH ST NW

ALBUQUERQUE,NM87102
71-0897107 		COMMUNITY NM 501(c)(3) Type I CSH
 
 
No
(41)CHI ST VINCENT HOSPITAL HOT SPRINGS
300 WERNER ST

HOT SPRINGS,AR71913
71-0236913 		HOSPITAL AR 501(c)(3) 3 CHISVHS
 
 
No
(42)CHI ST VINCENT HOT SPRINGS
300 WERNER ST

HOT SPRINGS,AR71913
26-1125064 		HOLDING CO AR 501(c)(3) Type II SVIMC
 
 
No
(43)CHI ST VINCENT MEDICAL GROUP HOT SPRINGS
300 WERNER ST

HOT SPRINGS,AR71913
26-1125131 		PHYSICIANS AR 501(c)(3) 3 CHISVHS
 
 
No
(44)COMMONSPIRIT HEALTH
198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
47-0617373 		HEALTHCARE CO 501(c)(3) Type I NA
 
 
No
(45)COMMONSPIRIT HEALTH OPERATING INVESTMENT POOL LLC
185 BERRY STREET STE 200

SAN FRANCISCO,CA94107
85-0919176 		INVESTMENTS CA 501(c)(3) Type I CSH
 
 
No
(46)COMMONSPIRIT HEALTH RESEARCH INSTITUTE
198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
27-1050565 		HEALTHCARE CO 501(c)(3) Type I CSH
 
 
No
(47)Community Hospital of San Bernardino
1805 Medical Center Drive

San Bernardino,CA92411
95-1643373 		HOSPITAL CA 501(c)(3) 3 Dignity Community Care
 
 
No
(48)COMMUNITY LIMITED CARE DIALYSIS CENTER
625 Eden Park Drive 7th Floor

CINCINNATI,OH45202
23-7419853 		HOLDING CO OH     GSH
 
 
No
(49)COMMUNITY MEMORIAL HOSPITAL MEDICAL SERVICE FOUNDATION
631 N 8TH ST

MISSOURI VALLEY,IA51555
42-1294399 		FUNDRAISING FOUNDATION IA 501(c)(3) Type I AH-CMHMV
 
 
No
(50)CONTINUING CARE HOSPITAL
One Saint Joseph Drive

LEXINGTON,KY40504
61-1400619 		HOSPITAL KY 501(c)(3) 3 SJHS
 
 
No
(51)Dignity Community Care
185 BERRY STREET STE 200

San Francisco,CA94107
81-5009488 		HOSPITAL CO 501(c)(3) 3 CSH
 
 
No
(52)DIGNITY HEALTH
185 BERRY STREET STE 200

SAN FRANCISCO,CA94107
94-1196203 		HOSPITAL CA 501(c)(3) 3 CSH
 
 
No
(53)Dignity Health Connected Living
200 Mercy Oaks Drive

Redding,CA96003
23-7115371 		Senior Center Services CA 501(c)(3) 7 Dignity Health
 
 
No
(54)Dignity Health Foundation
185 BERRY STREET STE 200

San Francisco,CA94107
46-2037641 		FUNDRAISING FOUNDATION CA 501(c)(3) Type I Dignity Health
 
 
No
(55)Dignity Health Foundation - Inland Empire
2101 N Waterman Avenue

San Bernardino,CA92404
23-7440086 		FUNDRAISING FOUNDATION CA 501(c)(3) Type I Dignity Health
 
 
No
(56)Dignity Health Foundation East Valley
475 South Dobson Road

Chandler,AZ85224
74-2418514 		FUNDRAISING FOUNDATION AZ 501(c)(3) Type I Dignity Health
 
 
No
(57)Dignity Health HPL Self-Insurance Trust
185 BERRY STREET STE 200

San Francisco,CA94107
94-3006034 		Self Insurance CA 501(c)(3) Type I Dignity Health
 
 
No
(58)Dignity Health Insurance Nevada Ltd
185 BERRY STREET STE 200

San Francisco,NV94107
81-3800752 		Self Insurance NV 501(c)(3) Type I Dignity Health
 
 
No
(59)Dignity Health Medical Foundation
3400 Data Drive

Rancho Cordova,CA95670
68-0220314 		MULTI-SPECIALTY OUTPATIENT MEDICAL CLINIC CA 501(c)(3) Type I Dignity Community Care
 
 
No
(60)Dignity Health Workers Comp Self-Insurance Trust
185 BERRY STREET STE 200

San Francisco,CA94107
94-6612446 		Self Insurance CA 501(c)(3) Type I Dignity Health
 
 
No
(61)Dominican Health Services
1555 Soquel Drive

Santa Cruz,CA95065
77-0056778 		Community Health System CA 501(c)(3) Type I Dignity Health
 
 
No
(62)Dominican Hospital Foundation
1555 Soquel Drive

Santa Cruz,CA95065
94-2450442 		FUNDRAISING FOUNDATION CA 501(c)(3) Type I Dignity Health
 
 
No
(63)Dominican Oaks Corporation
1555 Soquel Drive

Santa Cruz,CA95065
77-0127719 		Operation and management of housing complex to elderly persons CA 501(c)(3) 10 DHS
 
 
No
(64)East Texas Clinical Services
2801 VIA FORTUNA SUITE 500

AUSTIN,TX78746
45-4736213 		HEALTHCARE TX 501(c)(3) Type I SLHS
 
 
No
(65)ENUMCLAW REGIONAL HOSPITAL ASSOCIATION
1455 BATTERSBY AVE

ENUMCLAW,WA98022
91-0715805 		HOSPITAL WA 501(c)(3) 3 FHS
 
 
No
(66)FLAGET HEALTHCARE INC
4305 NEW SHEPHERDSVILLE RD

BARDSTOWN,KY40004
61-1345363 		HOSPITAL KY 501(c)(3) 3 KOH
 
 
No
(67)FLAGET MEMORIAL HOSPITAL FOUNDATION INC
4305 NEW SHEPHERDSVILLE RD

BARDSTOWN,KY40004
56-2351341 		FUNDRAISING FOUNDATION KY 501(c)(3) Type I FH
 
 
No
(68)FRANCISCAN CARE CENTER
4111 N HOLLAND-SYLVANIA RD

TOLEDO,OH43623
34-1931806 		HEALTHCARE OH 501(c)(3) 10 CHILC
 
 
No
(69)FRANCISCAN FOUNDATION
1717 SOUTH J ST

TACOMA,WA98405
91-1145592 		FUNDRAISING FOUNDATION WA 501(c)(3) 10 FHS
 
 
No
(70)FRANCISCAN HEALTH SYSTEM
1717 SOUTH J ST

TACOMA,WA98405
91-0564491 		HOSPITAL WA 501(c)(3) 3 CSH
 
 
No
(71)FRANCISCAN HEALTH VENTURES FKA SJMGROUP
TACOMA FNC CTR BLDG 1145 BROADWAY

TACOMA,WA98402
43-1882377 		PHYSICIANS MO 501(c)(3) 10 CSH
 
 
No
(72)FRANCISCAN MEDICAL GROUP
1313 BROADWAY STE 200

TACOMA,WA98402
91-1939739 		HEALTHCARE WA 501(c)(3) 10 FHS
 
 
No
(73)FRANCISCAN VILLA OF SOUTH MILWAUKEE INC
3601 S CHICAGO AVE

SOUTH MILWAUKEE,WI53172
39-1093829 		HEALTHCARE WI 501(c)(3) 10 CSH
 
 
No
(74)French Hospital Medical Center Foundation
1911 Johnson Avenue

San Luis Obispo,CA93401
20-3256125 		FUNDRAISING FOUNDATION CA 501(c)(3) Type I Dignity Community Care
 
 
No
(75)GARRISON MEMORIAL HOSPITAL
407 THIRD AVENUE SOUTHEAST

GARRISON,ND58540
45-0227752 		HOSPITAL ND 501(c)(3) 3 SAMC
 
 
No
(76)Glendale Memorial Health Foundation
1420 South Central Avenue

Glendale,CA91204
95-3625651 		FUNDRAISING FOUNDATION CA 501(c)(3) Type I Dignity Community Care
 
 
No
(77)GLOBAL HEALTH INITIATIVES
198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
20-1536108 		MINISTRIES CO 501(c)(3) Type I CSH
 
 
No
(78)GOOD SAMARITAN COLLEGE OF NURSING & HEALTH SCIENCE
625 Eden Park Drive 7th Floor

CINCINNATI,OH45202
31-1778403 		EDUCATION OH 501(c)(3) 2 GSH
 
 
No
(79)GOOD SAMARITAN FOUNDATION OF CINCINNATI INC
625 Eden Park Drive 7th Floor

CINCINNATI,OH45202
31-1206047 		FUNDRAISING FOUNDATION OH 501(c)(3) Type I GSH
 
 
No
(80)GOOD SAMARITAN HOSPITAL
PO BOX 1990

KEARNEY,NE68848
47-0379755 		HOSPITAL NE 501(c)(3) 3 CHI NEBRASKA
 
 
No
(81)GOOD SAMARITAN HOSPITAL FOUNDATION
111 W 31ST ST

KEARNEY,NE68847
47-0659443 		FUNDRAISING FOUNDATION NE 501(c)(3) 7 GSH
 
 
No
(82)HARRISON MEDICAL CENTER
2520 CHERRY AVE

BREMERTON,WA98310
91-0565546 		HOSPITAL WA 501(c)(3) 3 FHS
 
 
No
(83)HARRISON MEDICAL CENTER FOUNDATION
2520 CHERRY AVE

BREMERTON,WA98310
91-1197626 		FUNDRAISING FOUNDATION WA 501(c)(3) 7 HMC
 
 
No
(84)HEALTH FOUNDATION OF KENTUCKYONE INC
1451 HARRODSBURG RD STE D-308

LEXINGTON,KY40504
83-2170324 		FUNDRAISING FOUNDATION KY 501(c)(3) Type II KOH
 
 
No
(85)HEALTHCARE AND WELLNESS FOUNDATION
2400 ST FRANCIS DR

BRECKENRIDGE,MN56520
76-0761782 		FUNDRAISING FOUNDATION MN 501(c)(3) Type I SFMC
 
 
No
(86)HIGHLINE MEDICAL CENTER
16251 SYLVESTER RD SW

BURIEN,WA98166
91-0712166 		HOSPITAL WA 501(c)(3) 3 FHS
 
 
No
(87)HOUSE OF MERCY
1111 6TH AVE

DES MOINES,IA50314
42-1323808 		SHELTER IA 501(c)(3) 7 CHI-IA CORP
 
 
No
(88)JEWISH HOSPITAL AND ST MARY'S HEALTHCARE INC
250 E Liberty St Ste 500

LOUISVILLE,KY40202
61-1029768 		HOSPITAL KY 501(c)(3) 3 KOH
 
 
No
(89)KENTUCKYONE HEALTH INC
200 ABRAHAM FLEXNER WAY

LOUISVILLE,KY40202
61-1029769 		HEALTHCARE KY 501(c)(3) Type II CSH
 
 
No
(90)KENTUCKYONE HEALTH MEDICAL GROUP INC
100 E Liberty St Ste 800

LOUISVILLE,KY40202
61-1352729 		HEALTHCARE KY 501(c)(3) 10 JHSMH
 
 
No
(91)LAKEWOOD HEALTH CENTER
600 MAIN AVE S

BAUDETTE,MN56623
41-0758434 		HOSPITAL MN 501(c)(3) 3 CSH
 
 
No
(92)LAKEWOOD REGIONAL HEALTHCARE FOUNDATION
600 MAIN AVE S

BAUDETTE,MN56623
41-1893795 		FUNDRAISING FOUNDATION ND 501(c)(3) 7 LHC
 
 
No
(93)LISBON AREA HEALTH SERVICES
905 MAIN ST

LISBON,ND58054
82-0558836 		HOSPITAL ND 501(c)(3) 3 CSH
 
 
No
(94)LUFKIN VISION ACQUISITIONS
PO BOX 1447

LUFKIN,TX75901
82-0563768 		PROPERTY MGMT TX 501(c)(3) Type I MHSET
 
 
No
(95)MADISON ST JOSEPH HEALTH CENTER
2801 FRANCISCAN DRIVE

BRYAN,TX77802
74-2761145 		HOSPITAL TX 501(c)(3) 3 SJSC
 
 
No
(96)MADONNA MANOR INC
2344 AMSTERDAM ROAD

VILLA HILLS,KY51017
61-0654635 		LIVING ASSIST KY 501(c)(3) 10 CHILC
 
 
No
(97)Marian Regional Medical Center Foundation
1400 E Church Street

Santa Maria,CA93454
95-3818027 		FUNDRAISING FOUNDATION CA 501(c)(3) Type I Dignity Health
 
 
No
(98)Mark Twain Medical Center
768 Mountain Ranch Road

San Andreas,CA95249
68-0127677 		HOSPITAL CA 501(c)(3) 3 Dignity Community Care
 
 
No
(99)MEMORIAL HEALTH CARE SYSTEM FOUNDATION INC
2525 DE SALES AVE

CHATTANOOGA,TN37404
62-1839548 		FUNDRAISING FOUNDATION TN 501(c)(3) 7 MHCS
 
 
No
(100)MEMORIAL HEALTH CARE SYSTEM INC
2525 DE SALES AVE

CHATTANOOGA,TN37404
62-0532345 		HOSPITAL TN 501(c)(3) 3 CSH
 
 
No
(101)MEMORIAL HEALTH PARTNERS FOUNDATION INC
5600 BRAINERD RD STE 500

CHATTANOOGA,TN37411
03-0417049 		HEALTHCARE TN 501(c)(3) 10 MHCS
 
 
No
(102)MEMORIAL HEALTH SYSTEM OF EAST TEXAS
PO BOX 1447

LUFKIN,TX75902
75-0755367 		HOSPITAL TX 501(c)(3) 3 SLHS
 
 
No
(103)MEMORIAL MEDICAL CENTER - LIVINGSTON
PO BOX 1447

LUFKIN,TX75902
76-0436439 		HOSPITAL TX 501(c)(3) 3 MHSET
 
 
No
(104)MEMORIAL MEDICAL CENTER - SAN AUGUSTINE
PO BOX 1447

LUFKIN,TX75902
75-2663904 		HOSPITAL TX 501(c)(3) 3 MHSET
 
 
No
(105)MEMORIAL MULTISPECIALTY ASSOCIATES
1201 FRANK AVE

LUFKIN,TX95904
75-2721155 		PHYSICIANS TX 501(c)(3) Type I MHSET
 
 
No
(106)MEMORIAL SPECIALTY HOSPITAL
PO BOX 1447

LUFKIN,TX95902
75-2492741 		HOSPITAL TX 501(c)(3) 3 MHSET
 
 
No
(107)MERCY AUXILIARY OF CENTRAL IOWA
1111 6TH AVE

DES MOINES,IA50314
42-6076069 		AUXILIARY IA 501(c)(3) Type I MF-DM IA
 
 
No
(108)MERCY CLINICS INC
1111 6TH AVE

DES MOINES,IA50314
42-1193699 		PHYSICIANS IA 501(c)(3) 10 CHI-IA CORP
 
 
No
(109)MERCY COLLEGE OF HEALTH SCIENCES
1111 6TH AVE

DES MOINES,IA50314
42-1511682 		EDUCATION IA 501(c)(3) 2 CHI-IA CORP
 
 
No
(110)Mercy Foundation Bakersfield
PO Box 119

Bakersfield,CA93302
77-0201321 		FUNDRAISING FOUNDATION CA 501(c)(3) Type I Dignity Health
 
 
No
(111)MERCY FOUNDATION INC
2700 STEWART PKWY

ROSEBURG,OR97471
93-6088946 		FUNDRAISING FOUNDATION OR 501(c)(3) 7 MMC
 
 
No
(112)Mercy Foundation North
2625 Edith Avenue Suite E

Redding,CA96001
94-3136799 		Fundraising Foundation CA 501(c)(3)   NA
 
 
No
(113)MERCY FOUNDATION OF DES MOINES IA
1111 6TH AVE

DES MOINES,IA50314
23-7358794 		FUNDRAISING FOUNDATION IA 501(c)(3) 7 CHI-IA CORP
 
 
No
(114)Mercy Foundation Sacramento
3400 Data Drive 3rd Flr

Rancho Cordova,CA95670
23-7072762 		Fundraising Foundation CA 501(c)(3)   NA
 
 
No
(115)MERCY HEALTH CARE FOUNDATION
PO BOX 368

CORNING,IA50841
42-1461064 		FUNDRAISING FOUNDATION IA 501(c)(3)   AHMH-Corning
 
 
No
(116)MERCY HEALTHCARE FOUNDATION
570 CHAUTAUQUA BLVD

VALLEY CITY,ND58072
45-0435338 		FUNDRAISING FOUNDATION ND 501(c)(3)   MHVC
 
 
No
(117)MERCY HOSPITAL FOUNDATION COUNCIL BLUFFS
800 MERCY DR

COUNCIL BLUFFS,IA51503
42-1178204 		FUNDRAISING FOUNDATION IA 501(c)(3)   AHBMHS
 
 
No
(118)MERCY HOSPITAL OF DEVILS LAKE
1031 7TH ST NE

DEVILS LAKE,ND58301
45-0227012 		HOSPITAL ND 501(c)(3) 3 CSH
 
 
No
(119)MERCY HOSPITAL OF DEVILS LAKE FOUNDATION
1031 7TH ST NE

DEVILS LAKE,ND58301
35-2367360 		FUNDRAISING FOUNDATION ND 501(c)(3) 7 MHDL
 
 
No
(120)MERCY HOSPITAL OF VALLEY CITY
570 CHAUTAUQUA BLVD

VALLEY CITY,ND58072
45-0226553 		HOSPITAL ND 501(c)(3) 3 CSH
 
 
No
(121)Mercy McMahon Terrace
3865 J Street

Sacramento,CA95816
68-0117340 		Senior Citizen's Housing/Retirement Communities CA 501(c)(3) 10 Dignity Health
 
 
No
(122)MERCY MEDICAL CENTER
1301 15TH AVE WEST

WILLISTON,ND58801
45-0231183 		HOSPITAL ND 501(c)(3) 3 CSH
 
 
No
(123)MERCY MEDICAL CENTER - CENTERVILLE
ONE ST JOSEPHS DRIVE

CENTERVILLE,IA52544
42-0680308 		HOSPITAL IA 501(c)(3) 3 CHI-IA CORP
 
 
No
(124)MERCY MEDICAL CENTER - NEWTON DBA SKIFF MEDICAL CENTER
204 N 4th Ave E

Newton,IA50314
42-1470935 		HOSPITAL IA 501(c)(3) 3 CHI-IA CORP
 
 
No
(125)MERCY MEDICAL CENTER INC
2700 STEWART PKWY

ROSEBURG,OR97471
93-0386868 		HOSPITAL OR 501(c)(3) 3 CSH
 
 
No
(126)Mercy Medical Center Merced Foundation
301 E 13th Street

Merced,CA95340
77-0035928 		FUNDRAISING FOUNDATION CA 501(c)(3) Type I Dignity Health
 
 
No
(127)MERCY MEDICAL FOUNDATION
1301 15TH AVE WEST

WILLISTON,ND58801
45-0381803 		FUNDRAISING FOUNDATION ND 501(c)(3) Type I MMC
 
 
No
(128)NEBRASKA HEART HOSPITAL
7500 S 91ST ST

LINCOLN,NE68526
39-2031968 		HOSPITAL NE 501(c)(3) 3 CHI NEBRASKA
 
 
No
(129)Northland Healthcare Alliance
2223 East Rosser Avenue

Bismarck,ND58501
91-1845296 		MANAGEMENT ND 501(c)(3) 7 NCHA
 
 
No
(130)Northridge Hospital Foundation
18300 Roscoe Blvd

Northridge,CA91328
23-7444901 		FUNDRAISING FOUNDATION CA 501(c)(3) Type I Dignity Community Care
 
 
No
(131)OAKES COMMUNITY HOSPITAL
1200 N 7TH ST

OAKES,ND58474
45-0231675 		HOSPITAL ND 501(c)(3) 3 CSH
 
 
No
(132)OAKES COMMUNITY HOSPITAL FOUNDATION
1200 N 7TH ST

OAKES,ND58474
71-0966606 		FUNDRAISING FOUNDATION ND 501(c)(3) Type I OCH
 
 
No
(133)Pacific Central Coast Health Centers
1400 E Church Street

Santa Maria,CA93454
77-0447575 		Clinic CA 501(c)(3) 3 Dignity Community Care
 
 
No
(134)PINEYWOODS MEDICAL DEVELOPMENT CORP
PO BOX 1447

LUFKIN,TX75902
75-2493116 		PROPERTY MGMT TX 501(c)(3) Type I MHSET
 
 
No
(135)Port City Operating Company LLC
3400 Data Drive

Rancho Cordova,CA95670
46-5322209 		HOSPITAL CA 501(c)(3) 3 Dignity Health
 
 
No
(136)PROVIDENCE CARE CENTER
2025 HAYES AVENUE

SANDUSKY,OH44870
34-1658625 		HEALTHCARE OH 501(c)(3) 10 CHILC
 
 
No
(137)PROVIDENCE CARE CENTERS
2025 HAYES AVENUE

SANDUSKY,OH44870
34-1826099 		HOLDING CO OH 501(c)(3) Type II CHILC
 
 
No
(138)PROVIDENCE RESIDENTIAL COMMUNITY CORPORATION
5055 PROVIDENCE DRIVE

SANDUSKY,OH44870
34-1896807 		LIVING COMM OH 501(c)(3) 10 CHILC
 
 
No
(139)PUEBLO STEPUP
1925 E ORMAN AVE STE G52

PUEBLO,CO81004
84-1234295 		COMMUNITY CO 501(c)(3) 7 CHIC
 
 
No
(140)REGIONAL HOSPITAL FOR RESPIRATORY AND COMPLEX CARE
16251 Sylvester Road SW

Burien,WA98166
91-1170040 		HOSPITAL WA 501(c)(3) 3 FHS
 
 
No
(141)SAINT CLARE'S COMMUNITY CARE INC
25 POCONO RD

DENVILLE,NJ07834
22-2876836 		HEALTHCARE NJ 501(c)(3) 10 SCHS
 
 
No
(142)SAINT CLARE'S HEALTH SERVICES INC
25 POCONO RD

DENVILLE,NJ07834
22-3639733 		MANAGEMENT NJ 501(c)(3) 10 CSH
 
 
No
(143)SAINT CLARE'S HOSPITAL INC
25 POCONO RD

DENVILLE,NJ07834
22-3319886 		HEALTHCARE NJ 501(c)(3) 3 SCHS
 
 
No
(144)SAINT ELIZABETH FOUNDATION
555 S 70TH ST

LINCOLN,NE68510
47-0625523 		FUNDRAISING FOUNDATION NE 501(c)(3) 7 SERMC
 
 
No
(145)SAINT ELIZABETH HEALTH SERVICES
555 S 70TH ST

LINCOLN,NE68510
36-3233120 		HOSPITAL NE 501(c)(3) 3 SERMC
 
 
No
(146)SAINT ELIZABETH REGIONAL MEDICAL CENTER
555 S 70TH ST

LINCOLN,NE68510
47-0379836 		HOSPITAL NE 501(c)(3) 3 CHI NEBRASKA
 
 
No
(147)SAINT FRANCIS MEDICAL CENTER
2620 W FAIDLEY

GRAND ISLAND,NE68803
47-0376601 		HOSPITAL NE 501(c)(3) 3 CHI NEBRASKA
 
 
No
(148)SAINT FRANCIS MEDICAL CENTER FOUNDATION
PO BOX 9804

GRAND ISLAND,NE68802
47-0630267 		FUNDRAISING FOUNDATION NE 501(c)(3) 7 SFMC
 
 
No
(149)Saint Francis Memorial Hospital
900 Hyde Street

San Francisco,CA94109
94-1156295 		HOSPITAL CA 501(c)(3) 3 Dignity Community Care
 
 
No
(150)SAINT JOSEPH BEREA HOSPITAL FOUNDATION INC
305 ESTILL ST

BEREA,KY40403
26-0152877 		FUNDRAISING FOUNDATION KY 501(c)(3) 7 SJHS
 
 
No
(151)SAINT JOSEPH HEALTH SYSTEM INC
200 ABRAHAM FLEXNER WAY

LOUISVILLE,KY40202
61-1334601 		HOSPITAL KY 501(c)(3) 3 KOH
 
 
No
(152)SAINT JOSEPH HOSPITAL FOUNDATION INC
701 Bob Olink Dr 200

LEXINGTON,KY40504
61-1159649 		FUNDRAISING FOUNDATION KY 501(c)(3) Type I SJHS
 
 
No
(153)SAINT JOSEPH LONDON FOUNDATION INC
1001 SAINT JOSEPH LANE

LONDON,KY40741
26-0438748 		FUNDRAISING FOUNDATION KY 501(c)(3) 7 SJHS
 
 
No
(154)SAINT JOSEPH MOUNT STERLING FOUNDATION INC
225 FALCON DR

MOUNT STERLING,KY40353
27-2884584 		FUNDRAISING FOUNDATION KY 501(c)(3) 7 SJHS
 
 
No
(155)SAINT JOSEPH'S HOSPITAL FOUNDATION
2500 Fairway Street

DICKINSON,ND58601
36-3418207 		FUNDRAISING FOUNDATION ND 501(c)(3) Type I SJHHC
 
 
No
(156)San Gabriel Valley Medical Center Foundation
438 West Las Tunas Drive

San Gabriel,CA91776
95-3430341 		INACTIVE CA 501(c)(3) Type I Dignity Health
 
 
No
(157)SCHUYLER MEMORIAL HOSPITAL FOUNDATION INC
104 W 17TH ST

SCHUYLER,NE68661
36-3630014 		FUNDRAISING FOUNDATION NE 501(c)(3) Type I AHMHS
 
 
No
(158)Sequoia Hospital Foundation
170 Alameda de las Pulgas

Redwood City,CA94062
94-2909990 		Fundraising Foundation CA 501(c)(3) Type III-FI NA
 
 
No
(159)SET OF COLORADO SPRINGS INC
9100 E Mineral Circle

Centennial,CO80112
84-1183335 		Senior Center Services CO 501(c)(3) 7 CHIC
 
 
No
(160)Sierra Nevada Memorial-Miners Hospital
155 Glasson Way

Grass Valley,CA95945
94-1439787 		HOSPITAL CA 501(c)(3) 3 Dignity Community Care
 
 
No
(161)SJRMC JOPLIN MISSOURI
198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
44-0545809 		HOSPITAL MO 501(c)(3) 3 CSH
 
 
No
(162)ST ALEXIUS MEDICAL CENTER
900 EAST BROADWAY AVENUE

BISMARCK,ND58501
45-0226711 		HOSPITAL ND 501(c)(3) 3 CSH
 
 
No
(163)ST ANTHONY HOSPITAL
2801 St Anthony Way

PENDLETON,OR97801
93-0391614 		HOSPITAL OR 501(c)(3) 3 CSH
 
 
No
(164)ST ANTHONY HOSPITAL FOUNDATION
2801 St Anthony Way

PENDLETON,OR97801
93-0992727 		FUNDRAISING FOUNDATION OR 501(c)(3) Type I SAH
 
 
No
(165)ST ANTHONY'S HOSPITAL ASSOCIATION
FOUR HOSPITAL DR

MORRILTON,AR72110
71-0245507 		HOSPITAL AR 501(c)(3) 3 SVIMC
 
 
No
(166)ST CATHERINE HOSPITAL
401 EAST SPRUCE ST

GARDEN CITY,KS67846
48-0543721 		HOSPITAL KS 501(c)(3) 3 CSH
 
 
No
(167)ST CATHERINE HOSPITAL DEVELOPMENT FOUNDATION
401 EAST SPRUCE ST

GARDEN CITY,KS67846
20-0598702 		FUNDRAISING FOUNDATION KS 501(c)(3) Type I SCH
 
 
No
(168)ST CLARE COMMONS
12469 Five Point Road

TOLEDO,OH43551
27-0163752 		LIVING COMM OH 501(c)(3) 10 CHILC
 
 
No
(169)ST DOMINIC OF ONTARIO OREGON
198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
93-0433692 		HEALTHCARE OR     CSH
 
 
No
(170)St Francis Foundation of Santa Barbara
2323 De La Vina St Suite 104

Santa Barbara,CA93105
23-7137119 		FUNDRAISING FOUNDATION CA 501(c)(3) Type I Dignity Health
 
 
No
(171)ST FRANCIS HOME
2400 ST FRANCIS DR

BRECKENRIDGE,MN56520
41-0729978 		Long-TERM CARE MN 501(c)(3) 10 CSH
 
 
No
(172)St Francis Hospital Support Corporation
601 E Micheltorena Street

Santa Barbara,CA93103
77-0022302 		INACTIVE CA 501(c)(3) Type I Dignity Health
 
 
No
(173)ST FRANCIS LIFE CARE CORPORATION
19 POCONO RD

DENVILLE,NJ07834
22-2536017 		ELDERLY CARE NJ 501(c)(3) 8 SCHS
 
 
No
(174)ST FRANCIS MEDICAL CENTER
2400 ST FRANCIS DR

BRECKENRIDGE,MN56520
41-0695598 		HOSPITAL MN 501(c)(3) 3 CSH
 
 
No
(175)ST JOSEPH FOUNDATION OF BRYAN TEXAS
2801 FRANCISCAN DRIVE

BRYAN,TX77802
74-2351158 		FUNDRAISING FOUNDATION TX 501(c)(3) Type II SJSC
 
 
No
(176)ST JOSEPH MANOR
2801 FRANCISCAN DRIVE

BRYAN,TX77802
74-2847594 		HEALTHCARE TX 501(c)(3) 10 SJSC
 
 
No
(177)ST JOSEPH MEDICAL CENTER INC
201 INTERNATIONAL CIRCLE STE 212

HUNT VALLEY,MD21030
52-0591461 		HOSPITAL MD 501(c)(3) 3 CSH
 
 
No
(178)ST JOSEPH PHYSICIAN ASSOCIATES
2801 FRANCISCAN DRIVE

BRYAN,TX77802
20-3159302 		PHYSICIANS TX 501(c)(3) 3 SJSC
 
 
No
(179)ST JOSEPH PHYSICIAN ENTERPRISE INC
201 INTERNATIONAL CIRCLE STE 212

HUNT VALLEY,MD21030
52-1311775 		PHYSICIANS MD 501(c)(3) Type I SJMC
 
 
No
(180)ST JOSEPH REGIONAL HEALTH CENTER
2801 FRANCISCAN DRIVE

BRYAN,TX77802
74-1282696 		HOSPITAL TX 501(c)(3) 3 SJSC
 
 
No
(181)ST JOSEPH REGIONAL HEALTH PARTNERS
2801 FRANCISCAN DRIVE

BRYAN,TX77802
45-4088170 		HOSPITAL TX 501(c)(3) 3 SJSC
 
 
No
(182)ST JOSEPH REGIONAL HEALTH PARTNERS ACO
2801 FRANCISCAN DRIVE

BRYAN,TX77802
46-3265423 		HEALTHCARE TX 501(c)(3) 10 SJSC
 
 
No
(183)ST JOSEPH SERVICES CORPORATION
2801 FRANCISCAN DRIVE

BRYAN,TX77802
74-2455161 		MANAGEMENT TX 501(c)(3) Type I SLHS
 
 
No
(184)St Josephs Foundation
350 West Thomas Road

Phoenix,AZ85013
94-2941245 		FUNDRAISING FOUNDATION AZ 501(c)(3) Type I Dignity Health
 
 
No
(185)St Josephs Foundation of San Joaquin
1800 N California Street

Stockton,CA95204
51-0432777 		FUNDRAISING FOUNDATION CA 501(c)(3) Type I Dignity Health
 
 
No
(186)ST JOSEPH'S AREA HEALTH SERVICES
600 PLEASANT AVE

PARK RAPIDS,MN56470
41-0695603 		HOSPITAL MN 501(c)(3) 3 CSH
 
 
No
(187)ST JOSEPH'S HOSPITAL AND HEALTH CENTER
2500 Fairway St

DICKINSON,ND58601
45-0226429 		HOSPITAL ND 501(c)(3) 3 CSH
 
 
No
(188)ST LEONARD
8100 CLYO ROAD

CENTERVILLE,OH45458
34-1940863 		LIVING COMM OH 501(c)(3) 10 CHILC
 
 
No
(189)ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - PMC
6624 FANNIN ST STE 2505

HOUSTON,TX77030
27-3733278 		HOSPITAL TX 501(c)(3) 3 SLHS
 
 
No
(190)ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - SUGAR LAND
6624 FANNIN ST STE 2505

HOUSTON,TX77030
26-1947374 		HOSPITAL TX 501(c)(3) 3 SLHS
 
 
No
(191)ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - THE WOODLANDS
6624 FANNIN ST STE 2505

HOUSTON,TX77030
26-0335902 		HOSPITAL TX 501(c)(3) 3 SLHS
 
 
No
(192)ST LUKE'S COMMUNITY HEALTH SERVICES
6624 FANNIN ST STE 1100

HOUSTON,TX77030
76-0536234 		HOSPITAL TX 501(c)(3) 3 SLHS
 
 
No
(193)ST LUKE'S FOUNDATION
1213 HERMANN DRIVE STE 855

HOUSTON,TX77004
45-3811485 		FUNDRAISING FOUNDATION TX 501(c)(3) 7 SLHS
 
 
No
(194)ST LUKE'S HEALTH SYSTEM CORPORATION
PO Box 20269

HOUSTON,TX77225
76-0536232 		MANAGEMENT TX 501(c)(3) Type I CSH
 
 
No
(195)ST LUKE'S HOSPITAL AT THE VINTAGE
6624 FANNIN ST STE 2505

HOUSTON,TX77030
26-3734606 		HOSPITAL TX 501(c)(3) 3 SLHS
 
 
No
(196)ST LUKE'S PROPERTIES CORPORATION
1213 Hermann Drive Ste 855

HOUSTON,TX77004
76-0531716 		PROPERTY MGMT TX 501(c)(3) Type I SLHS
 
 
No
(197)ST LUKE'S SUGAR LAND PROPERTIES CORPORATION
6624 FANNIN ST STE 2505

HOUSTON,TX77030
45-4120549 		PROPERTY MGMT TX 501(c)(3) Type I SLCDC-SL
 
 
No
(198)St Mary Medical Center Foundation
1050 Linden Avenue

Long Beach,CA90813
23-7153876 		FUNDRAISING FOUNDATION CA 501(c)(3) Type I Dignity Health
 
 
No
(199)St Mary Professional Building Inc
1050 Linden Avenue

Long Beach,CA90813
23-7373088 		INACTIVE CA 501(c)(3) Type I Dignity Health
 
 
No
(200)St Marys Medical Center Foundation
450 Stanyan Street

San Francisco,CA94117
94-3336143 		FUNDRAISING FOUNDATION CA 501(c)(3) Type I Dignity Health
 
 
No
(201)ST MARY'S COMMUNITY HOSPITAL
1301 Grundman Boulevard

NEBRASKA CITY,NE68410
47-0443636 		HOSPITAL NE 501(c)(3) 3 CHI NEBRASKA
 
 
No
(202)ST MARY'S HOSPITAL FOUNDATION
1314 3RD AVE

NEBRASKA CITY,NE68410
47-0707604 		FUNDRAISING FOUNDATION NE 501(c)(3) 7 SMCH
 
 
No
(203)St Rose Dominican Health Foundation
3001 St Rose Parkway

Henderson,NV89052
88-0349432 		FUNDRAISING FOUNDATION NV 501(c)(3) Type I Dignity Health
 
 
No
(204)ST VINCENT FOUNDATION
TWO ST VINCENT CIRCLE

LITTLE ROCK,AR72205
51-0169537 		FUNDRAISING FOUNDATION AR 501(c)(3) Type I SVIMC
 
 
No
(205)ST VINCENT INFIRMARY MEDICAL CENTER
TWO ST VINCENT CIRCLE

LITTLE ROCK,AR72205
71-0236917 		HOSPITAL AR 501(c)(3) 3 CSH
 
 
No
(206)ST VINCENT MEDICAL GROUP
TWO ST VINCENT CIRCLE

LITTLE ROCK,AR72205
71-0830696 		HEALTHCARE AR 501(c)(3) 10 SVIMC
 
 
No
(207)SYLVANIA FRANCISCAN HEALTH
1715 INDIAN WOOD CIR 200

MAUMEE,OH43537
34-1412964 		HEALTHCARE OH 501(c)(3) 3 CSH
 
 
No
(208)SYLVANIA FRANCISCAN HEALTH FOUNDATION
1715 INDIAN WOOD CIR 200

MAUMEE,OH43537
45-5357161 		FUNDRAISING FOUNDATION OH 501(c)(3) 3 SFH
 
 
No
(209)THE COMMONS OF PROVIDENCE
5000 PROVIDENCE DRIVE

SANDUSKY,OH44870
34-1826097 		ASSIST LIVING OH 501(c)(3) Type I CHILC
 
 
No
(210)THE COMMUNITY HOSPITAL OF BRAZOSPORT
100 MEDICAL DRIVE

LAKE JACKSON,TX77566
74-1385192 		HOSPITAL TX 501(c)(3) 3 SLHS
 
 
No
(211)THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OH
625 Eden Park Drive 7th Floor

CINCINNATI,OH45202
31-0537486 		HOSPITAL OH 501(c)(3) 3 CSH
 
 
No
(212)THE PHYSICIAN NETWORK
2000 Q ST STE 500

LINCOLN,NE68503
47-0780857 		PHYSICIANS NE 501(c)(3) Type I CHI NEBRASKA
 
 
No
(213)TOTAL HEALTHCARE
9100 E Mineral Circle

Centennial,CO80112
84-0927232 		HOSPITAL CO 501(c)(3) 3 CHIC
 
 
No
(214)TRINITY HEALTH FOUNDATION
380 SUMMIT AVENUE

STEUBENVILLE,OH43952
31-1329423 		FUNDRAISING FOUNDATION OH 501(c)(3) Type I THS
 
 
No
(215)TRINITY HEALTH SYSTEM
380 SUMMIT AVENUE

STEUBENVILLE,OH43952
34-1818681 		HEALTHCARE OH 501(c)(3) Type I NA
 
 
No
(216)TRINITY HOSPITAL TWIN CITY
819 NORTH FIRST STREET

DENNISON,OH44621
27-5401105 		HOSPITAL OH 501(c)(3) 3 THS
 
 
No
(217)TRI-STATE HEALTH SERVICES INC
ONE ROSS PARK BLVD

STEUBENVILLE,OH43952
34-1522484 		ASSIST LIVING OH 501(c)(3) 7 THS
 
 
No
(218)UNITY FAMILY HEALTHCARE
815 SE 2ND ST

LITTLE FALLS,MN56345
41-0721642 		HOSPITAL MN 501(c)(3) 3 CSH
 
 
No
(219)VILLA NAZARETH INC
801 PAGE DR

FARGO,ND58103
45-0226714 		Long-TERM CARE ND 501(c)(3) 10 CSH
 
 
No
(220)VISITING NURSE ASSOCIATION OF ST CLARE'S INC
191 WOODPORT RD

SPARTA,NJ07871
22-1768334 		HOME HEALTH NJ 501(c)(3) 10 SCHS
 
 
No
(221)Woodland Memorial Hospital Foundation
1321 Cottonwood Street 305

Woodland,CA95695
94-6167964 		Fundraising Foundation CA 501(c)(3) 7 NA
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) American Mercy Home Care LLC

1700 EDISON DR
MILFORD,OH45150
83-0486150 		HOME HEALTH OH NA
  		N/A 0 0   No 0   No  
(2) ARIZONA CARE NETWORK - NEXT LLC

350 W Thomas Rd
Phoenix,AZ85018
47-4696671 		Care Network AZ NA
  		N/A 0 0   No 0   No  
(3) Arizona Care Network LLC

350 W Thomas Rd
Phoenix,AZ85013
45-4494682 		Care Network AZ NA
  		N/A 0 0   No 0   No  
(4) Audubon Land Company LLC

630 Southpointe Court 200
COLORADO SPRINGS,CO80906
84-1513085 		Real Estate CO NA
  		N/A 0 0   No 0   No  
(5) AVON EMERGENCY AND URGENT CARE CENTER LLC

9100 E Mineral Circle
Centennial,CO80112
81-1727282 		HEALTHCARE SRVC CO NA
  		N/A 0 0   No 0   No  
(6) BAYLOR CHI ST LUKES HEALTH SERVICES LLC

6624 Fannin St Ste 1100
HOUSTON,TX77030
47-2079184 		HEALTHCARE SRVC TX NA
  		N/A 0 0   No 0   No  
(7) BERGAN MERCY SURGERY CENTER LLC

7710 Mercy Rd Ste 200
OMAHA,NE68124
20-8671994 		AMBUL SURG CTR NE NA
  		N/A 0 0   No 0   No  
(8) BERYWOOD OFFICE PROPERTIES LLC

2501 Citico Avenue
CHATTANOGA,TN37404
62-1875199 		PHYS OFFICE TN NA
  		N/A 0 0   No 0   No  
(9) BIOLIFE DIGNITY HEALTH INTERNATIONAL LTD

 
 
Health Services CH NA
  		N/A 0 0   No 0   No  
(10) BLUEGRASS REGIONAL IMAGING CENTER

1218 SOUTH BROADWAY STE 310
LEXINGTON,KY40504
61-1386736 		DIAGNOSTIC IMAGING KY NA
  		N/A 0 0   No 0   No  
(11) CBCC Outsmarting Cancer LLC

6501 Truxtun Avenue
Bakersfield,CA93309
46-1602286 		Radiation / Oncology CA NA
  		N/A 0 0   No 0   No  
(12) CENTRAL NEBRASKA REHABILITATION SERVICES LLC

3004 W FAIDLEY AVENUE
GRAND ISLAND,NE68803
81-0653461 		Physical Therapy NE NA
  		N/A 0 0   No 0   No  
(13) CENTURA-SCA HOLDINGS LLC

569 BROOK VILLAGE STE 901
BIRMINGHAM,AL35209
47-4823023 		OP SURGERY CENTER AL NA
  		N/A 0 0   No 0   No  
(14) CHI OPERATING INVESTMENT PROGRAM LP

198 INVERNESS DRIVE WEST
ENGLEWOOD,CO80112
47-0727942 		INVESTMENTS CO NA
  		N/A 0 0   No 0   No  
(15) CHICAMSURG Surgery Centers LLC

1A Burton Hills Blvd
Nashville,TN37215
46-5683027 		SURGERY CENTER CO NA
  		N/A 0 0   No 0   No  
(16) Colorado Springs CK Leasing LLC

630 Southpointe Court 200
COLORADO SPRINGS,CO80906
26-2982714 		REAL ESTATE CO NA
  		N/A 0 0   No 0   No  
(17) Community Mercy Home Care Services of Springfield LLC

1700 EDISON DR
MILFORD,OH45150
31-1746556 		HOME HEALTH OH NA
  		N/A 0 0   No 0   No  
(18) DE JV LLC

8686 New Trails Drive
The Woodlands,TX77381
32-0496548 		Emergency Care NV NA
  		N/A 0 0   No 0   No  
(19) DHHP Surgery Centers LLC

1513 S Grand Avenue Ste 350
Los Angeles,CA90015
83-1847466 		SURGERY CA NA
  		N/A 0 0   No 0   No  
(20) DHRT Holdings LLC

185 Berry Street Suite 200
San Francisco,CA94107
35-2484591 		Holding Company DE NA
  		N/A 0 0   No 0   No  
(21) Dignity- GoHealth Urgent Care Management LLC

5555 Glenridge Connector Suite 700
Atlanta,GA30342
35-2548698 		Management Services DE NA
  		N/A 0 0   No 0   No  
(22) Dignity Health at Home LLC

1700 EDISON DR
MILFORD,OH45150
82-4674115 		HEALTHCARE SRVC DE NA
  		N/A 0 0   No 0   No  
(23) Dignity Health Specialty Pharmacy LLC

185 Berry Street Suite 200
San Francisco,CA94107
32-0589462 		Specialty Pharmacy Services DE NA
  		N/A 0 0   No 0   No  
(24) Dignity Home Recovery Care LLC

49 Music Square West Suite 401
Nashville,TN37203
83-2832522 		Home Recovery Program DE NA
  		N/A 0 0   No 0   No  
(25) DIGNITYUSP LAS VEGAS SURGERY CENTERS LLC

15305 Dallas Parkway
Suite 1600 LB 28
Addison,TX75001
20-2999237 		Surgery TX NA
  		N/A 0 0   No 0   No  
(26) DignityUSP NorCal Surgery Centers LLC

15305 Dallas Parkway
Suite 1600 LB 28
Addison,TX75001
20-2468509 		SURGERY TX NA
  		N/A 0 0   No 0   No  
(27) DIGNITYUSP PHOENIX SURGERY CENTERS LLC

15305 Dallas Parkway
Suite 1600 LB 28
Addison,TX75001
13-4248908 		Surgery TX NA
  		N/A 0 0   No 0   No  
(28) DignityUSPJohn Muir East Bay Surg Ctrs LLC

15305 Dallas Parkway
Suite 1600 LB 28
Addison,TX75001
35-2584991 		SURGERY TX NA
  		N/A 0 0   No 0   No  
(29) Dignity-Abrazo Health Network LLC

3030 N Central Avenue Suite 1402
Phoenix,AZ85012
46-5477985 		Management Services AZ NA
  		N/A 0 0   No 0   No  
(30) Dominican Magnetic Resonance Imaging Center

1545 Soquel Drive
Santa Cruz,CA94065
77-0095477 		Imaging Center CA NA
  		N/A 0 0   No 0   No  
(31) ECCS ACQUISITION COMPANY LLC

2940 NORTH CIRCLE DRIVE
COLORADO SPRINGS,CO80909
35-2656413 		AMBUL SURG CTR CO NA
  		N/A 0 0   No 0   No  
(32) Folsom Sierra Endoscopy Center LP

1650 Creekside Drive 1600
Folsom,CA95630
68-0482416 		Endoscopy CA NA
  		N/A 0 0   No 0   No  
(33) Franciscan Medical Pavilion Bonney Lake LLC

6622 Wollochet Dr NW
Gig Harbor,WA98335
46-3494108 		Real Estate WA NA
  		N/A 0 0   No 0   No  
(34) FRANCISCAN SPECIALTY CARE LLC

680 SOUTH FOURTH STREET
LOUISVILLE,KY40202
81-3725123 		HEALTHCARE SRVC WA NA
  		N/A 0 0   No 0   No  
(35) Good Samaritan Home Care Services of Vincenne IN LLC

1700 EDISON DR
MILFORD,OH45150
20-1792869 		HOME HEALTH OH NA
  		N/A 0 0   No 0   No  
(36) HC SL VINTAGE I LLC

18000 W SARAH LANE STE 250
BROOKFIELD,WI53045
27-0453767 		PROPERTY HOLDING WI NA
  		N/A 0 0   No 0   No  
(37) HEALTHCARE SUPPORT SERVICES LLC

PO BOX 9804
GRAND ISLAND,NE68802
72-1546196 		LAUNDRY NE NA
  		N/A 0 0   No 0   No  
(38) Heartland Oncology LLC

2337 E Crawford St
Salina,KS67401
46-4265403 		ONCOLOGY KS NA
  		N/A 0 0   No 0   No  
(39) LAKESIDE AMBULATORY SURGICAL CENTER LLC

17031 LAKESIDE HILLS DR
OMAHA,NE68130
20-4267902 		AMBUL SURG CTR NE NA
  		N/A 0 0   No 0   No  
(40) LAKESIDE ENDOSCOPY CENTER LLC

17001 LAKESIDE HILLS PLZ STE 201
OMAHA,NE68130
20-5544496 		ENDOSCOPY SRVC NE NA
  		N/A 0 0   No 0   No  
(41) LINCOLN CK LEASING LLC

555 SOUTH 70TH STREET
Lincoln,NE68510
26-2496856 		Real Estate NE NA
  		N/A 0 0   No 0   No  
(42) Memorial Medical Plaza

3838 San Dimas Suite B 201
Bakersfield,CA93301
36-4510880 		Real estate CA NA
  		N/A 0 0   No 0   No  
(43) Mercy Davis Cancer Center Management Co LLC

2740 M Street
Merced,CA95340
94-3358445 		Management of Cancer Center CA NA
  		N/A 0 0   No 0   No  
(44) Mercy Rehabilitation Hospital LLC

680 SOUTH FOURTH STREET
LOUISVILLE,KY40202
81-4437201 		HEALTHCARE SRVC TX NA
  		N/A 0 0   No 0   No  
(45) Military Road Properties LLC

181 S 333rd Street STE 250
Federal Way,WA98003
91-2067879 		Real Estate WA NA
  		N/A 0 0   No 0   No  
(46) NEBRASKA SPINE HOSPITAL LLC

6901 N 72ND ST STE 20300
OMAHA,NE68122
27-0263191 		SPINE HOSPITAL NE NA
  		N/A 0 0   No 0   No  
(47) NICU Operating CO of Santa Cruz LLC

1555 Soquel Drive
Santa Cruz,CA95065
46-0502935 		Neonatal Healthcare CA NA
  		N/A 0 0   No 0   No  
(48) NORTH RIVER SURGERY CENTER LLC

2209 WILDWOOD AVE
SHERWOOD,AR72120
71-0799771 		AMBUL SURG CTR AR NA
  		N/A 0 0   No 0   No  
(49) NORTHERN PLAINS LABORATORY LLC

401 N 9 STREET
BISMARK,ND58501
84-1641341 		Diagnostic Services ND NA
  		N/A 0 0   No 0   No  
(50) NSC Channel Islands LLC

3000 Riverchase Galleria Suite 500
Birmingham,AL35244
77-0418197 		Ambulatory surgical center CA NA
  		N/A 0 0   No 0   No  
(51) OMG Arizona LLC

130 Sutter Street 2nd Flr
San Francisco,CA94104
47-1708588 		Medical Office AZ NA
  		N/A 0 0   No 0   No  
(52) ORTHOCOLORADO LLC

11650 WEST 2ND PLACE
LAKEWOOD,CO80228
37-1577105 		ORTHO HOSPITAL CO NA
  		N/A 0 0   No 0   No  
(53) Park Rapids Area Health Care

600 Pleasant Avenue S
Park Rapids,MN56470
20-4926259 		HEALTHCARE SRVC MN NA
  		N/A 0 0   No 0   No  
(54) Pasadena Urgency Center LLC

4600 E SAM HOUSTON PKWY SOUTH
PASADENA,TX77505
81-2482854 		URGENT CARE TX NA
  		N/A 0 0   No 0   No  
(55) Patient Transport Services of Columbus Inc

1700 EDISON DR
MILFORD,OH45150
26-4601285 		Ambulance OH NA
  		N/A 0 0   No 0   No  
(56) PENINSULA RADIATION ONCOLOGY LLC

314 MLK JR WAY STE 11
TACOMA,WA98405
87-0808610 		HEALTHCARE SRVC WA NA
  		N/A 0 0   No 0   No  
(57) Penrad Imaging LLC

1390 Kelly Johnson Blvd
COLORADO SPRINGS,CO80920
84-1072619 		Medical Imaging CO NA
  		N/A 0 0   No 0   No  
(58) Performance Medical Equipment & Respiratory Svsc LLC

19625 62nd Avenue South STE 101
Kent,WA98032
45-2901632 		Holding Company WA NA
  		N/A 0 0   No 0   No  
(59) Plaza Surgery Center LP

525 E Plaza Drive Suite 100
Santa Maria,CA93454
77-0573567 		Surgery CA NA
  		N/A 0 0   No 0   No  
(60) PMC HOSPITAL LLC

3100 MAIN ST STE 500
HOUSTON,TX77002
27-3280598 		HOSPITAL TX NA
  		N/A 0 0   No 0   No  
(61) Precision Medicine Alliance LLC

198 INVERNESS DRIVE WEST
ENGLEWOOD,CO80112
35-2569159 		Diagnostic Services CO NA
  		N/A 0 0   No 0   No  
(62) Pueblo Ambulatory Surgery Center LLC

25 Montebello Rd
Pueblo,CO81003
62-1488737 		SURGERY CENTER CO NA
  		N/A 0 0   No 0   No  
(63) Radiation Oncology Centers of Ventura County

1700 N ROSE AVENUE SUITE 120
OXNARD,CA93030
77-0191706 		IMAGING CA NA
  		N/A 0 0   No 0   No  
(64) RBR Management LLC

91 Corporate Park Drive Suite 120
Henderson,NV89074
27-1466450 		Ambulance NV NA
  		N/A 0 0   No 0   No  
(65) Reid-ANC Home Care Services LLC

1700 EDISON DR
MILFORD,OH45150
37-1454747 		HOME HEALTH IN NA
  		N/A 0 0   No 0   No  
(66) SAINT JOSEPH - SCA HOLDINGS LLC

1451 Harrodsburg RD
LEXINGTON,KY40503
45-3801157 		OP SURGERY DE NA
  		N/A 0 0   No 0   No  
(67) SAINT JOSEPH-ANC HOME CARE SERVICES

1700 EDISON DR
MILFORD,OH45150
26-3330545 		HOME HEALTH KY NA
  		N/A 0 0   No 0   No  
(68) Santa Cruz Comprehensive Imaging LLC

1661 Soquel Drive Suite G
Santa Cruz,CA95065
01-0550623 		Imaging CA NA
  		N/A 0 0   No 0   No  
(69) Santa Cruz Land & Building LP

1555 Soquel Drive
Santa Cruz,CA95065
77-0285236 		REAL ESTATE CA NA
  		N/A 0 0   No 0   No  
(70) Santa Cruz Surgery Center LLC

3003 PAUL SWEET ROAD
SANTA CRUZ,CA95065
77-0194916 		SURGERY CA NA
  		N/A 0 0   No 0   No  
(71) Southeastern Home Care LLC

1700 EDISON DR
MILFORD,OH45150
27-1219638 		HOME HEALTH OH NA
  		N/A 0 0   No 0   No  
(72) St Joseph's Surgery Center LP

15305 Dallas Parkway
Suite 1600 LB 28
Addison,TX75001
20-1019390 		Surgery TX NA
  		N/A 0 0   No 0   No  
(73) St Elizabeth Home Care Services LLC

1700 EDISON DR
MILFORD,OH45150
26-1236191 		HOME HEALTH KY NA
  		N/A 0 0   No 0   No  
(74) ST FRANCIS LAND COMPANY

5390 N ACADEMY BLVD STE 300
COLORADO SPRINGS,CO80918
26-3134100 		REAL ESTATE CO NA
  		N/A 0 0   No 0   No  
(75) ST LUKE'S DIAGNOSTIC CATH LAB LLP

6624 FANNIN ST STE 800
HOUSTON,TX77030
71-0959365 		DIAGNOSTICS TX NA
  		N/A 0 0   No 0   No  
(76) ST LUKE'S LAKESIDE HOSPITAL LLC

6624 FANNIN STE 2505
HOUSTON,TX77030
30-0427437 		HOSPITAL TX NA
  		N/A 0 0   No 0   No  
(77) ST LUKE'S THE WOODLANDS SLEEP CENTER LLC

6624 FANNIN STE 800
HOUSTON,TX77030
46-2795726 		DIAGNOSTICS TX NA
  		N/A 0 0   No 0   No  
(78) Templeton Surgery Center LLC

1310 Las Tablas Road Suite 104
Templeton,CA94365
20-2246616 		Surgery CA NA
  		N/A 0 0   No 0   No  
(79) The Medical Pavilion at St John's

1700 Rose Avenue
Oxnard,CA93030
77-0332349 		Real Estate CA NA
  		N/A 0 0   No 0   No  
(80) THREE SPRING IMAGING LLC

1 Mercado St STE 200A
DURANGO,CO81301
81-3571570 		HEALTHCARE SRVC CO NA
  		N/A 0 0   No 0   No  
(81) Valley Physicians Surgery Center At Northridge LLC

18330 Roscoe Blvd
Northridge,CA91328
80-0864336 		Surgery CA NA
  		N/A 0 0   No 0   No  
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) Alegent HealthCreighton St Joseph Managed Care Services Inc

12809 West Dodge Rd
Omaha,NE68154
47-0802396 		Managed Care NE NA
  		C Corporation 0 0     No
(2) All Saints Insurance Company SPC Ltd

PO BOX 10073 APO
Georgetown,GRAND CAYMAN  
CJ
98-0556913 		Insurance CJ NA
  		C Corporation 0 0     No
(3) ALLIANCE HEALTH PROVIDERS OF BRAZOS Valley Inc

2801 FRANCISCAN DRIVE
BRYAN,TX77802
74-2466914 		Healthcare TX NA
  		C Corporation 0 0     No
(4) Alternative Insurance Management Service Inc

3900 OLYMPIC BLVD STE 400
Erlanger,KY41018
84-1112049 		Management Services CO NA
  		C Corporation 0 0     No
(5) AMERICAN NURSING CARE Inc

1700 EDISON DR
MILFORD,OH45150
31-1085414 		HOME HEALTH OH NA
  		C Corporation 0 0     No
(6) AMERIMED INC

1700 EDISON DR
MILFORD,OH45150
31-1158699 		HOME HEALTH OH NA
  		C Corporation 0 0     No
(7) BC HOLDING COMPANY INC

1850 BLUEGRASS AVE
LOUISVILLE,KY40215
31-1542851 		Fitness Club KY NA
  		C Corporation 0 0     No
(8) BrazoSport Health Alliance

1 WEST WAY COURT
LAKE JACKSON,TX77566
76-0518376 		Health Care TX NA
  		C Corporation 0 0     No
(9) Caduceus Medical Associates INC

5600 Brainerd Road Ste 500
Chattanooga,TN37411
62-1570736 		Healthcare TN NA
  		C Corporation 0 0     No
(10) Captive Management Initiatives Ltd

PO BOX 10073 APO
Georgetown,GRAND CAYMAN  
CJ
98-0663022 		Captive Management CJ NA
  		C Corporation 0 0     No
(11) Catholic Health Initiatives Center for Translational Research

198 INVERNESS DRIVE WEST
Englewood,CO80112
27-2269511 		Research CO NA
  		C Corporation 0 0     No
(12) CHI St Luke's Health - Memorial Condominium Association Inc

1201 W Frank Ave
Lufkin,TX75904
83-4184717 		Condo Assoc TX NA
  		C Corporation 0 0     No
(13) ClearRiver Health

198 INVERNESS DRIVE WEST
Englewood,CO80112
46-4495960 		Insurance TN NA
  		C Corporation 0 0     No
(14) Coastal Surgical Specialists Inc

921 Oak Park Blvd Suite 101
Pismo Beach,CA93449
74-3000596 		Healthcare CA NA
  		S Corporation 0 0     No
(15) Comcare Services Inc

5570 DTC Parkway
Englewood,CO80111
84-0904813 		Inactive CO NA
  		C Corporation 0 0     No
(16) CONSOLIDATED HEALTH SERVICES

1700 EDISON DR
MILFORD,OH45150
31-1378212 		HOME HEALTH OH NA
  		C Corporation 0 0     No
(17) Des Moines Medical Center Inc

1111 6TH AVE
Des Moines,IA50314
42-0837382 		Real Estate IA NA
  		C Corporation 0 0     No
(18) Dignity Health Holding Corporation

185 Berry Street Suite 200
San Francisco,CA94107
46-0675371 		Holding Co NV NA
  		C Corporation 0 0     No
(19) Dignity Health Insurance Ltd

PO Box 1051
Grand Cayman Islands,GRAND CAYMANKY11102
CJ
98-1065338 		Insurance CJ NA
  		C Corporation 0 0     No
(20) Dignity Health Provider Resources Inc

185 Berry Street Suite 200
San Francisco,CA94107
47-3366764 		Health Plan CA NA
  		C Corporation 0 0     No
(21) Diversified Health Resources Inc

100 MEDICAL DRIVE
LAKE JACKSON,TX77566
76-0222679 		Health Care TX NA
  		C Corporation 0 0     No
(22) First Initiatives Insurance LTD

PO BOX 10073 APO
Georgetown,GRAND CAYMAN  
CJ
98-0203038 		Insurance CJ NA
  		C Corporation 0 0     No
(23) Franciscan City Urgent Care Svcs PS dba City MD-Franciscan UC

1345 AVE OF THE AMERICAS
NEW YORK,NY10105
81-2174959 		Healthcare NY NA
  		C Corporation 0 0     No
(24) Franciscan Services Inc

198 INVERNESS DRIVE WEST
Englewood,CO80112
23-2487967 		Healthcare CO NA
  		C Corporation 0 0     No
(25) Good Samaritan Outreach Services

PO Box 1990
Kearney,NE68848
47-0659440 		Medical Clinic NE NA
  		C Corporation 0 0     No
(26) HarvestPlains Health of Iowa

32129 Weyerhaeuser Way S STE 201
FEDERAL WAY,WA98001
47-3451750 		Insurance WA NA
  		C Corporation 0 0     No
(27) Health Services of the Pacific Central Coast Inc

1400 E Church Street
Santa Maria,CA93454
77-0074057 		Healthcare CA NA
  		C Corporation 0 0     No
(28) Health Systems Enterprises Inc

PO BOX 1990
Kearney,NE68848
47-0664558 		MGMT NE NA
  		C Corporation 0 0     No
(29) Healthcare MGMT Services Organization INC

1149 MARKET ST
Tacoma,WA98402
91-1865474 		Health Org. WA NA
  		C Corporation 0 0     No
(30) HeartlandPlains Health

198 INVERNESS DRIVE WEST
Englewood,CO80112
46-4368223 		Insurance NE NA
  		C Corporation 0 0     No
(31) Highline Medical Group

1717 S J Street
Tacoma,WA98405
91-1407026 		Medical Services WA NA
  		C Corporation 0 0     No
(32) Integrated Medical Services

9250 N 3rd Street Suite 4010
Phoenix,AZ85020
86-0783428 		Multi-specialty physicians group AZ NA
  		C Corporation 0 0     No
(33) KOMG-Louisville Region Inc

201 Abraham Flexner Way
Louisville,KY40202
83-2481198 		Healthcare KY NA
  		C Corporation 0 0     No
(34) Medical Office Building Horizontal Property Regime Inc

300 Werner St
Hot Springs,AR71913
71-0720429 		Real Estate AR NA
  		C Corporation 0 0     No
(35) Medquest

1301 15TH AVENUE WEST
Williston,ND58801
45-0392137 		Sale of DME ND NA
  		C Corporation 0 0     No
(36) Memorial CV Service Line Management Company LLC

1201 W Frank Ave
Lufkin,TX75904
46-3622849 		Heath Care TX NA
  		C Corporation 0 0     No
(37) Mercy Park Apartments LTD

1111 6th AVE
Des Moines,IA50314
42-1202422 		Housing IA NA
  		C Corporation 0 0     No
(38) Mercy Services Corp

2700 STEWART PARKWAY
Roseburg,OR97471
93-0824308 		Retail Sales OR NA
  		C Corporation 0 0     No
(39) MHI Clinical Services

1201 W Frank Ave
Lufkin,TX75904
46-1967952 		Healthcare TX NA
  		C Corporation 0 0     No
(40) Millennium Surgery Center Inc

9300 Stockdale Hwy 200
Bakersfield,CA93311
77-0513445 		Healthcare CA NA
  		S Corporation 0 0     No
(41) Mountain Management Services Inc

6028 Shallowford Rd
Chattanooga,TN37421
62-1570739 		MGMT SVC ORG TN NA
  		C Corporation 0 0     No
(42) North Central Health Care Alliance

PO Box 5538
Bismark,ND58506
45-0439894 		Healthcare ND NA
  		C Corporation 0 0     No
(43) PATIENT TRANSPORT SERVICES INC

1700 EDISON DR
MILFORD,OH45150
31-1100798 		HOME HEALTH OH NA
  		C Corporation 0 0     No
(44) QualChoice Advantage

32129 WEYERHAEUSER WAY S STE 201
FEDERAL WAY,WA98001
47-3433912 		Insurance WA NA
  		C Corporation 0 0     No
(45) QualChoice Health Plan Svs Inc (fka CollabHealth Plan Svs Inc)

198 INVERNESS DRIVE WEST
Englewood,CO80112
46-1224037 		Admin Services CO NA
  		C Corporation 0 0     No
(46) QualChoice Health Inc (fka CollabHealth Managed Solutions Inc)

198 INVERNESS DRIVE WEST
Englewood,CO80112
46-1222808 		Holding Co CO NA
  		C Corporation 0 0     No
(47) QualChoice Holdings Inc

198 INVERNESS DRIVE WEST
Englewood,CO80112
27-4075520 		Holding Co AR NA
  		C Corporation 0 0     No
(48) QualChoice of Nebraska

2401 S 73rd St
Omaha,NE68124
81-0738827 		Inactive NE NA
  		C Corporation 0 0     No
(49) RiverLink Health

198 INVERNESS DRIVE WEST
Englewood,CO80112
46-4380824 		Insurance OH NA
  		C Corporation 0 0     No
(50) RiverLink Health of Kentucky Inc

198 INVERNESS DRIVE WEST
Englewood,CO80112
46-4828332 		Insurance KY NA
  		C Corporation 0 0     No
(51) Ross Park Pharmacy Inc

380 SUMMIT AVE
STEUBENVILLE,OH43952
34-1832654 		Pharmacy OH NA
  		C Corporation 0 0     No
(52) Saint Clare's Primary Care Inc

198 INVERNESS DRIVE WEST
Englewood,CO80112
22-2441202 		Billing Services NJ NA
  		C Corporation 0 0     No
(53) SJH Services Corporation

198 INVERNESS DRIVE WEST
Englewood,CO80112
23-2307408 		Healthcare CO NA
  		C Corporation 0 0     No
(54) SJL PHYSICIAN MANAGEMENT SERVICES INC

424 LEWIS HARGETT CR STE 160
Lexington,KY40503
27-0164198 		Mgmt KY NA
  		C Corporation 0 0     No
(55) SoundPath Health Inc

32129 Weyerhaeuser Way S STE 201
Federal Way,WA98001
42-1720801 		Insurance WA NA
  		C Corporation 0 0     No
(56) St Mary Health Ventures Inc

1050 Linden Avenue
Long Beach,CA90813
95-1912528 		Retail Pharmacy CA NA
  		C Corporation 0 0     No
(57) St Anthony Development Company

1415 Southgate
Pendleton,OR97801
93-1216943 		Athletic Club OR NA
  		C Corporation 0 0     No
(58) St Joseph Development Company Inc

1717 SOUTH J ST
Tacoma,WA98405
91-1480569 		Rental WA NA
  		C Corporation 0 0     No
(59) St Luke's Health System Holdings Inc

6624 Fannin STE 800
Houston,TX77030
76-0637138 		Holding Co TX NA
  		C Corporation 0 0     No
(60) St Vincent Community Health Services Inc

TWO ST VINCENT CIRCLE
Little Rock,AR72205
71-0710785 		Healthcare AR NA
  		C Corporation 0 0     No
(61) STE Holdings

12809 West Dodge Rd
Omaha,NE68154
82-2383629 		Holding Co NE NA
  		C Corporation 0 0     No
(62) Sugar Land Doctor Group

1317 Lake Point Parkway
Sugar Land,TX77478
45-4270163 		Medical Clinic TX NA
  		C Corporation 0 0     No
(63) Towson Management Inc

7601 OSLER DR
Towson,MD21204
52-1710750 		Mgmt Services MD NA
  		C Corporation 0 0     No
(64) TRINITY MANAGEMENT SERVICES ORGANIZATION

380 SUMMIT AVE
STEUBENVILLE,OH43952
34-1471026 		Mgmt Services OH NA
  		C Corporation 0 0     No
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
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
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
 
No
q Reimbursement paid by related organization(s) for expenses ............................
1q
 
No
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved





Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
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) 2019

Additional Data


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Software Version: 2019v5.0