TY 2021 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(1) JOYCE DOMBROUSKI...................................................................... CORPORATE MEMBER	1.00 ................. 54.00	X		829,870	157,213
(2) JANI HUSTON...................................................................... DIRECTOR	0.50 ................. 49.50	X		221,804	29,916
(3) DEVIN HUNTLEY...................................................................... DIRECTOR	0.50 ................. 54.50	X		204,090	19,841
(4) FRAN ALBRECHT...................................................................... CHIEF PHILANTHROPY OFFICER	50.00 ................. 0.00		X	187,352	25,795
(5) CAROL BENSEN...................................................................... DIRECTOR	0.50 ................. 49.50	X		129,913	26,526
(6) ERIN STEELE...................................................................... SECRETARY	1.00 ................. 0.00	X	X	0	0
(7) KYLE RYAN...................................................................... CO-VICE CHAIR	1.00 ................. 0.00	X	X	0	0
(8) LARRY WHITE...................................................................... CHAIR - THRU 12/21	1.00 ................. 0.00	X	X	0	0
(9) NICOLE RIEKER...................................................................... TREASURER	1.00 ................. 0.00	X	X	0	0
(10) STEPHEN HIRO MD...................................................................... CHAIR	1.00 ................. 0.00	X	X	0	0
(11) TOM SEVERSON...................................................................... CO-VICE CHAIR	1.00 ................. 0.00	X	X	0	0
(12) ALICE MARQUARDT...................................................................... DIRECTOR (PART YEAR)	0.50 ................. 0.00	X		0	0
(13) COLLEEN POWERS...................................................................... DIRECTOR	0.50 ................. 0.00	X		0	0
(14) DAN PROPP MD...................................................................... DIRECTOR	0.50 ................. 0.00	X		0	0
(15) GREGORY KAZEMI MD...................................................................... DIRECTOR	0.50 ................. 0.00	X		0	0
(16) HERB DEPP...................................................................... DIRECTOR - THRU 2/21	0.50 ................. 0.00	X		0	0
(17) KEVIN MILTKO...................................................................... DIRECTOR	0.50 ................. 0.00	X		0	0

- TIN:

SCHEDULE A
(Form 990)

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

2021

Open to Public
Inspection

Name of the organization

ST PATRICK HOSPITAL FOUNDATION

Employer identification number

23-7056976

Part I

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

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

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

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

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

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

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

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

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

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

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

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

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

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

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

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

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

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

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

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

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

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


Total

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

Cat. No. 11285F

Schedule A (Form 990) 2021

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)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..	4,333,712	4,118,214	12,455,934	5,128,682	5,473,674	31,510,216
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	4,333,712	4,118,214	12,455,934	5,128,682	5,473,674	31,510,216
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) ..						16,387,747
6	Public support. Subtract line 5 from line 4.						15,122,469

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(f) Total
7	Amounts from line 4..	4,333,712	4,118,214	12,455,934	5,128,682	5,473,674	31,510,216
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...	286,876	368,864	435,356	385,223	588,383	2,064,702
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.)..	104					104
11	Total support. Add lines 7 through 10						33,575,022

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

343,614

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2021 (line 6, column (f) divided by line 11, column (f)) .........

45.040 %

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

44.290 %

16a

33 1/3% support test—2021. If the organization did not check the box on line 13, and line 14 is 33 1/3 % or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2020. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2021. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2020. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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

Schedule A (Form 990) 2021

Page 3

Part III

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

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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 on line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2021 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2020 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2021 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2020 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2021. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2020. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

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

Schedule A (Form 990) 2021

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

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

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

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

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

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

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

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

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

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

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

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

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

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

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

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

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

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

10a

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

10a

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

10b

Schedule A (Form 990) 2021

Page 5

Part IV

Supporting Organizations (continued)

Yes

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

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

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

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

Section C. Type II Supporting Organizations

Yes

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

Section D. All Type III Supporting Organizations

Yes

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

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

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

Section E. Type III Functionally-Integrated Supporting Organizations

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

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

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

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

Activities Test. Answer lines 2a and 2b below.

Yes

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

Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

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

Schedule A (Form 990) 2021

Page 6

Part V

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

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

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

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 0.015 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 0.035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

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

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

Schedule A (Form 990) 2021

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	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2021 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2021	(iii) Distributable Amount for 2021
1 Distributable amount for 2021 from Section C, line 6
2 Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2021:
a From 2016.......
b From 2017.......
c From 2018.......
d From 2019.......
e From 2020.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2021 distributable amount
i Carryover from 2016 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2021 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2021 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2021, 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 2021. 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 2022. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2017.....
b Excess from 2018.....
c Excess from 2019.....
d Excess from 2020.....
e Excess from 2021.....

Schedule A (Form 990) (2021)

Schedule A (Form 990) 2021

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 II, LINE 10, EXPLANATION OF OTHER INCOME:	MISCELLANEOUS REVENUE - 2017 AMOUNT: $ 104.

Schedule A (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

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

OMB No. 1545-0047

2021

Name of the organization

ST PATRICK HOSPITAL FOUNDATION

Employer identification number

23-7056976

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

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

General Rule

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

Special Rules

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

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

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

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

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

Cat. No. 30613XSchedule B (Form 990) (2021)

Schedule B (Form 990) (2021) Page 2

Name of organization ST PATRICK HOSPITAL FOUNDATION

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	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2021)

Schedule B (Form 990) (2021)

Page 3

Name of organization ST PATRICK HOSPITAL FOUNDATION		Employer identification number 23-7056976

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) (2021)

Schedule B (Form 990) (2021)

Page 4


Name of organization ST PATRICK HOSPITAL FOUNDATION			Employer identification number 23-7056976
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

Schedule B (Form 990) (2021)

Additional Data

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Software Version:

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SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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

Attach to Form 990.
SchDMd Bullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

ST PATRICK HOSPITAL FOUNDATION

Employer identification number

23-7056976

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 ........

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

Yes No

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

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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


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

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

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

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

Yes No

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

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

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

Yes No

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

Part III

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

If the organization elected, as permitted under 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.

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

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:

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

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

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

Cat. No. 52283D

Schedule D (Form 990) 2021

Page 2

Part III

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

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

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

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

Yes No

Part IV

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

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

Yes No


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

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

Yes No

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

Part V

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

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

1a	Beginning of year balance ....	1,165,096	3,532,978	2,877,365	3,079,076	2,852,204
b	Contributions ...	1,739,363	15,000	200,554	93,738	6,830
c	Net investment earnings, gains, and losses	-605,120	66,889	544,202	-163,661	274,975
d	Grants or scholarships ...	146,984			131,788	54,933
e	Other expenditures for facilities and programs ...		2,438,606	89,143
f	Administrative expenses ....		11,165
g	End of year balance ......	2,152,355	1,165,096	3,532,978	2,877,365	3,079,076

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

Board designated or quasi-endowment SchDMd Bullet

0 %

Permanent endowment SchDMd Bullet

100.000 %

Term endowment SchDMd Bullet

0 %

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

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

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

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

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

Part VI

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

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

1a	Land .....	58,221		58,221
b	Buildings ....	950,100	745,831	204,269
c	Leasehold improvements
d	Equipment ....	31,281	22,876	8,405
e	Other .....
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				270,895

Schedule D (Form 990) 2021

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)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

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

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

Part IX

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

(a) Description				(b) Book value
(1)CHARITABLE GIFT ANNUITIES				1,232,248
(2)DUE FROM AFFILIATES				11,947,896
(3)CHARITABLE REMAINDER UNITRUSTS				133,353
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				13,313,497

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
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	17,970,700
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) 2021

Page 4

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

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

Part XIII

Supplemental Information

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

Return Reference

Explanation

PART V, LINE 4:

THE ENDOWED FUNDS OF ST. PATRICK HOSPITAL FOUNDATION ARE INVESTED AND EXPENDED ACCORDING TO OUR ENDOWMENT INVESTMENT POLICY AND ENDOWMENT SPENDING POLICY. THESE POLICIES ARE INTENDED TO COMPLY WITH UPMIFA IN THE USE OF ENDOWED FUNDS TO SUPPORT THE STATED GOALS OF THE ORIGINAL DONORS. ENDOWED FUNDS ARE CURRENTLY DIRECTED TOWARD SOCIAL ISSUES AND CHARITY, CANCER TREATMENT, METABOLIC DISEASES, THE MEDICAL LIBRARY, EDUCATION, ST PATRICK HOUSE AND THE MISSION OF ST PATRICK HOSPITAL FOUNDATION.

Schedule D (Form 990) 2021

Additional Data

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SCHEDULE G (Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

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

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

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization
ST PATRICK HOSPITAL FOUNDATION

Employer identification number

23-7056976

Part I

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

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

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

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

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

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

YesNo

If "Yes," list the 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
	GHIORSI & SORRENTI INC 255 MADISON AVENUE WYCKOFF, NJ07481	CAPITAL CAMPAIGN CONSULTING		No	2,864,863	80,000	2,784,863
	ALLIANCE PHILANTHROPY LLC 27459 FRONTAGE ROAD BOZEMAN, MT59715	CAPITAL CAMPAIGN CONSULTING		No	2,784,863	30,000	2,754,863








Total . . . . . . . . . . . . . . . . . . . .					5,649,726	110,000	5,539,726

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) 2021

Page 2

Part II

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

		(a) Event #1 (event type)	(b) Event #2 (event type)	(c) Other events (total number)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .
2	Less: Contributions . . . .
3	Gross income (line 1 minus line 2) . . . . . .

4	Cash prizes . . . . .
5	Noncash prizes . . . .
6	Rent/facility costs . . . .
7	Food and beverages . . .
8	Entertainment . . . .
9	Other direct expenses . . .
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .

Part III

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

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

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

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

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

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

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

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

YesNo

If "No," explain:

10a

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

YesNo

If "Yes," explain:

Schedule G (Form 990) 2021

Page 3

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

YesNo

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

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

YesNo

Indicate the percentage of gaming activity conducted in:

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

13a

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

13b

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

Name

Address

15a

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

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

YesNo

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

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

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

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

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

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

YesNo

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

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

Part IV

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

Return Reference	Explanation
PART I, LINE 2B, COLUMN (V)	ST. PATRICK HOSPITAL FOUNDATION HAS ENGAGED GHIORSI & SORRENTI, INC. AND ALLIANCE PHILANTHROPY, LLC FOR CAPITAL CAMPAIGN MANAGEMENT SERVICES. THE AGREEMENT REQUIRES A FIXED FEE PAYMENT FOR THE CONSULTING SERVICES AND PERMITS REIMBURSEMENT OF EXPENSES UP TO 15% OF THE TOTAL CONSULTING FEE.

Schedule G (Form 990) 2021

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

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

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

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

Attach to Form 990.
lBullet

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

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization
ST PATRICK HOSPITAL FOUNDATION

Employer identification number
23-7056976

Part I

General Information on Grants and Assistance

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

Yes No

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

Part II

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

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

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(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) PROVIDENCE HEALTH & SERVICES - MONTANA 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057	81-0231793	501(C)(3)	10,124,014	0			OPERATIONAL SUPPORT
(2) PROVIDENCE ST JOSEPH MEDICAL CENTER 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057	81-0463482	501(C)(3)	511,432	0			OPERATIONAL SUPPORT

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

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

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

Cat. No. 50055P

Schedule I (Form 990) 2021

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) PATIENT ASSISTANCE	186	90,862
(2) SCHOLARSHIPS AND PROFESSIONAL DEVELOPMENT	31	18,809
(3) EMPLOYEE ASSISTANCE	38	29,258
(3)
(4)
(5)
(6)
(7)

Part IV

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

Return Reference

Explanation

PART I, LINE 2:

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

Schedule I (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

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

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

Attach to Form 990.
SchJMediumBullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

ST PATRICK HOSPITAL FOUNDATION

Employer identification number

23-7056976

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

If any of the boxes 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 .....

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? ....

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

Yes

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 2021

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, 1099-MISC compensation, and/or 1099-NEC			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1JOYCE DOMBROUSKI CORPORATE MEMBER	(i) (ii)	0 ------------- 429,701	0 ------------- 100,728	0 ------------- 299,441	0 ------------- 141,071	0 ------------- 16,142	0 ------------- 987,083	0 ------------- 272,969
2JANI HUSTON DIRECTOR	(i) (ii)	0 ------------- 161,854	0 ------------- 39,513	0 ------------- 20,437	0 ------------- 19,437	0 ------------- 10,479	0 ------------- 251,720	0 ------------- 0
3DEVIN HUNTLEY DIRECTOR	(i) (ii)	0 ------------- 176,613	0 ------------- 26,554	0 ------------- 923	0 ------------- 8,989	0 ------------- 10,852	0 ------------- 223,931	0 ------------- 0
4FRAN ALBRECHT CHIEF PHILANTHROPY OFFICER	(i) (ii)	0 ------------- 144,816	0 ------------- 41,690	0 ------------- 846	0 ------------- 9,293	0 ------------- 16,502	0 ------------- 213,147	0 ------------- 0
5CAROL BENSEN DIRECTOR	(i) (ii)	0 ------------- 100,003	0 ------------- 28,350	0 ------------- 1,560	0 ------------- 12,581	0 ------------- 13,945	0 ------------- 156,439	0 ------------- 0

Schedule J (Form 990) 2021

Page 3

Part III

Supplemental Information

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

Return Reference	Explanation
PART I, LINE 1A	PROVIDENCE EXPENSE REIMBURSEMENT PROCEDURES INCLUDE THE FOLLOWING POLICIES: FIRST CLASS TRAVEL OR CHARTER TRAVEL AIR TRAVEL IS GENERALLY REIMBURSABLE AT THE LEAST EXPENSIVE AIRFARE WHICH PERMITS DEPARTURES AND ARRIVALS AT REASONABLE TIMES AND REASONABLE DISTANCE TRAVELED. EMPLOYEES ARE ENCOURAGED TO PLAN IN ADVANCE TO GET AVAILABLE DISCOUNTS. AIRLINE FREQUENT FLYER UPGRADES WILL NEVER BE REIMBURSED. IN LIMITED SITUATIONS, FIRST CLASS TICKETS AND CHARTER MAY BE REIMBURSED WHEN APPROVED BY A SENIOR LEVEL SUPERVISOR. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS TAX INDEMNIFICATIONS OR GROSS-UP PAYMENTS - RELOCATION PROVIDENCE FOLLOWS THE FEDERAL AND STATE TAXATION LAWS RELATED TO RELOCATION EXPENSES PAID TO THE EMPLOYEE OR TO A THIRD PARTY ON THE EMPLOYEE'S BEHALF. THEY ARE CONSIDERED TAXABLE WAGES AND ARE REPORTED AS SUCH. BASED ON THE WAY PROVIDENCE HAS CHOSEN TO PAY THE RELOCATION EXPENSES, PROVIDENCE REPORTS REIMBURSEMENTS AND PAYMENTS TO VENDORS AS INCOME AND THESE EXPENSE PAYMENTS ARE REFLECTED ON THE EXECUTIVE'S FORM W-2. PROVIDENCE PROVIDES A GROSS-UP FOR THE RELOCATION BENEFITS, SO THAT A PORTION OF THE REIMBURSEMENT DOES NOT HAVE TO BE USED TO PAY TAXES, AND THIS TAX GROSS-UP IS ALSO REPORTED AS TAXABLE INCOME. THE AMOUNTS REPORTED FOR THESE GROSS-UP PAYMENTS ARE INCLUDED ON SCHEDULE J, PART II, COLUMN B (III) - OTHER REPORTABLE COMPENSATION ON THE FORM 990. TAX INDEMNIFICATIONS OR GROSS-UP PAYMENTS - FINANCIAL/RETIREMENT PLANNING PROVIDENCE FOLLOWS THE FEDERAL AND STATE TAXATION LAWS RELATED TO FINANCIAL AND RETIREMENT PLANNING EXPENSES PAID TO THE EMPLOYEE OR TO A THIRD PARTY ON THE EMPLOYEE'S BEHALF. THEY ARE CONSIDERED TAXABLE WAGES AND ARE REPORTED AS SUCH. BASED ON THE WAY PROVIDENCE HAS CHOSEN TO PAY THESE OTHER EXPENSES, PROVIDENCE REPORTS REIMBURSEMENTS AND PAYMENTS TO VENDORS AS INCOME AND THESE EXPENSE PAYMENTS ARE REFLECTED ON THE EXECUTIVE'S FORM W-2. PROVIDENCE PROVIDES A GROSS-UP FOR THIS BENEFIT, SO THAT A PORTION OF THE PAYMENT DOES NOT HAVE TO BE USED TO PAY TAXES, AND THIS TAX GROSS-UP IS ALSO REPORTED AS TAXABLE INCOME. THE AMOUNTS REPORTED FOR THESE GROSS-UP PAYMENTS ARE INCLUDED ON SCHEDULE J, PART II, COLUMN B (III) - OTHER REPORTABLE COMPENSATION ON THE FORM 990. PERSONAL SERVICES PROVIDENCE OFFERS FINANCIAL PLANNING SERVICES AS AN OPTIONAL BENEFIT TO EMPLOYEES AT VICE PRESIDENT LEVEL AND ABOVE. THE AMOUNTS REPORTED FOR THE FINANCIAL PLANNING SERVICES ARE INCLUDED AS TAXABLE INCOME ON SCHEDULE J, PART II, COLUMN B (III) - OTHER REPORTABLE COMPENSATION ON THE FORM 990 FOR THE EMPLOYEES WHO PARTICIPATE.
PART I, LINE 3	DESCRIPTION OF PROCESS TO REVIEW COMPENSATION PAID TO TOP MANAGEMENT OFFICIAL THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/TOP MANAGEMENT OFFICIAL IS PAID BY ITS TAX-EXEMPT PARENT, PROVIDENCE HEALTH & SERVICES - MONTANA, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O, PART VI, LINE 15A FOR THE PROCESS USED BY PROVIDENCE.
PART I, LINE 4B	ENTITIES WITHIN THE PROVIDENCE SYSTEM SPONSOR NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS FOR CERTAIN EXECUTIVES. THE PLANS PROVIDE FOR EMPLOYER CONTRIBUTIONS BASED ON A PERCENTAGE OF EXECUTIVE BASE SALARY AND, DEPENDING ON THE PLAN, ARE SUBJECT TO EITHER A THREE YEAR, AGE 59 1/2 OR A FIVE YEAR, AGE 65 VESTING SCHEDULE. UNTIL THE EXECUTIVE PROVIDES THESE SUBSTANTIAL FUTURE SERVICES, THESE SUPPLEMENTAL RETIREMENT CONTRIBUTIONS ARE AT RISK, AND WILL BE FORFEITED IF THE EXECUTIVE LEAVES THE ORGANIZATION BEFORE REACHING HER OR HIS VESTING DATE. THE SUPPLEMENTAL RETIREMENT CONTRIBUTIONS ARE INCLUDED IN COLUMN (C) AS A NONTAXABLE BENEFIT IN THE YEAR THE CONTRIBUTION IS CREDITED TO THE EXECUTIVE'S ACCOUNT, AND ARE INCLUDED AGAIN ON THE FORM 990 IN COLUMN (B)(III) IF AND WHEN THE AMOUNT BECOMES VESTED IN A FUTURE YEAR, AS THE FORM 990 REQUIRES. THE FOLLOWING INDIVIDUAL RECEIVED A PAYOUT DURING THE CURRENT YEAR: JOYCE DOMBROUSKI - $272,969
PART I, LINE 7	NON-FIXED PAYMENTS THE PROVIDENCE EXECUTIVE COMPENSATION COMMITTEE (OF THE BOARD) HAS APPROVED AN EXECUTIVE COMPENSATION PHILOSOPHY THAT CLOSELY TIES AN EXECUTIVE'S COMPENSATION TO PERFORMANCE - BOTH THE PERFORMANCE OF THE ORGANIZATION AND THE PERFORMANCE OF THE EXECUTIVE. THERE IS NO GUARANTEE THAT THIS PART OF A LEADER'S COMPENSATION WILL BE PAID - IF THE PERFORMANCE OF THE ORGANIZATION OR OF THE INDIVIDUAL DOES NOT MEET THE PERFORMANCE STANDARDS FOR PAYMENT, NO PERFORMANCE-BASED PAYMENT IS MADE. THIS APPROACH IS REFLECTED IN PROVIDENCE'S LEADERSHIP ANNUAL INCENTIVE PLAN, WHICH IS A PERFORMANCE-BASED ANNUAL INCENTIVE PLAN THAT AFFORDS PARTICIPATING EXECUTIVES THE OPPORTUNITY TO EARN "AT RISK" COMPENSATION THROUGH PERFORMANCE AGAINST VERY CHALLENGING GOALS. PAYOUTS WILL BE AWARDED BASED ON GOALS RELATED TO STRATEGIC OBJECTIVES, FISCAL STEWARDSHIP AND QUALITY OF CARE - THESE GOALS ARE SET BEFORE THE YEAR BEGINS AND ARE VERY CHALLENGING. THE EXECUTIVE COMPENSATION COMMITTEE REVIEWS AND APPROVES EACH YEAR'S PERFORMANCE GOALS TO MAKE SURE THEY ARE SUFFICIENTLY CHALLENGING, AND TO MAKE SURE THE GOALS ARE DESIGNED TO HELP PROVIDENCE MEET ITS MISSION AND STRATEGIC PURPOSES. EACH YEAR THE PSJH BOARD EXECUTIVE COMPENSATION COMMITTEE REVIEWS THE INCENTIVE PERFORMANCE AND MUST CERTIFY THE ACHIEVEMENT OF PERFORMANCE GOALS BEFORE ANY AWARDS ARE PAID OUT. WHEN REVIEWING AND APPROVING TOTAL COMPENSATION FOR EXECUTIVES, THE EXECUTIVE COMPENSATION COMMITTEE INCLUDES INCENTIVE AWARDS, TO MAKE SURE THAT COMPENSATION IS REASONABLE AND WELL-SUPPORTED BY MARKET DATA. THE COMMITTEE CONSISTS ONLY OF DIRECTORS WHO ARE FREE OF CONFLICTS OF INTEREST, AND THE COMMITTEE RELIES ON MARKET SURVEY DATA GATHERED BY AN INDEPENDENT CONSULTANT. THE COMMITTEE CONDUCTS THIS REVIEW AND APPROVAL PROCESS IN A MANNER THAT IS IN ACCORDANCE WITH IRS REQUIREMENTS FOR COMPENSATION OF TAX-EXEMPT ORGANIZATION LEADERS, AND IN ACCORDANCE WITH THE BEST GOVERNANCE PRACTICES IN THE INDUSTRY.

Schedule J (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990)

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

2021

Open to Public
Inspection

Name of the organization

ST PATRICK HOSPITAL FOUNDATION

Employer identification number

23-7056976

Return Reference	Explanation
FORM 990, PART I, LINE 1, DESCRIPTION OF ORGANIZATION MISSION:	AS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE.
FORM 990, PART V, LINE 1A	PROVIDENCE HEALTH & SERVICES - MONTANA PAYS ALL VENDORS FOR ST. PATRICK HOSPITAL FOUNDATION FROM ITS SHARED SERVICES. PROVIDENCE HEALTH & SERVICES - MONTANA ISSUES FORM 1099-MISC UNDER ITS TAX ID NUMBER AND COMPLIES WITH BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS.
FORM 990, PART VI, SECTION A, LINE 6	CLASSES OF MEMBERS OR STOCKHOLDERS PROVIDENCE HEALTH & SERVICES - MONTANA IS THE SOLE CORPORATE MEMBER OF ST. PATRICK HOSPITAL FOUNDATION.
FORM 990, PART VI, SECTION A, LINE 7A	CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS ST. PATRICK HOSPITAL FOUNDATION HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBERS RESERVE THE RIGHT TO APPOINT THE ST. PATRICK HOSPITAL FOUNDATION'S GOVERNING BOARD. ALL NOMINATIONS THAT COME FROM THE ST. PATRICK HOSPITAL FOUNDATION BOARD AS NOMINATIONS MUST BE APPROVED BY PROVIDENCE HEALTH & SERVICES - MONTANA, AS THE CORPORATE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7B	CLASSES OF PERSONS, DECISIONS REQUIRING APPROVAL & TYPE OF VOTING RIGHTS THE FOLLOWING POWERS RESIDE WITH THE CORPORATE MEMBER: 1) TO ADOPT OR CHANGE THE MISSION, PHILOSOPHY, AND VALUES, INCLUDING THE STRATEGIC PLAN AND MISSION STATEMENT. 2) TO AMEND OR REPEAL THE ARTICLES OF INCORPORATION OR BYLAWS. 3) TO APPROVE THE ACQUISITION OF ASSETS, THE INCURRENCE OF INDEBTEDNESS OR THE LEASE, SALE TRANSFER, ASSIGNMENT OR ENCUMBERING OF ASSETS EXCEEDING A SPECIFIED THRESHOLD, OR THE SALE OR TRANSFER OF ANY PROPERTY WHICH MAY HAVE HISTORICAL OR RELIGIOUS SIGNIFICANCE. 4) TO APPROVE THE DISSOLUTION OR LIQUIDATION. 5) TO APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS. 6) TO APPOINT THE CERTIFIED PUBLIC ACCOUNTANTS. 7) TO APPROVE THE CLOSURE OF ANY INSTITUTION OR MAJOR ENTITY OR WORK OF THE CORPORATION.
FORM 990, PART VI, SECTION B, LINE 11B	PROCESS TO REVIEW 990 THE FORM 990 WAS PREPARED BASED ON INFORMATION RECEIVED FROM VARIOUS DEPARTMENTS OF THE ORGANIZATION INCLUDING THE FINANCE TEAM, HUMAN RESOURCES, PAYROLL, COMPLIANCE AND THE GENERAL COUNSEL'S OFFICE. THE ORGANIZATION ENGAGED AN OUTSIDE ACCOUNTING FIRM TO PREPARE THE RETURN. THE RETURN HAS BEEN REVIEWED BY AN OFFICER OF THE ORGANIZATION. A FULL COPY OF THE FORM 990 WAS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING WITH THE IRS. THE AUDIT COMMITTEE OF THE PARENT ORGANIZATION IS PROVIDED AN ANNUAL UPDATE ON THE TAX REPORTING PROCESS AND KEY DISCLOSURES.
FORM 990, PART VI, SECTION B, LINE 12C	PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST PROVIDENCE TAKES THE ISSUE OF CONFLICTS OF INTEREST, AND INDEPENDENT UNCONFLICTED DECISION-MAKING, VERY SERIOUSLY. PROVIDENCE HAS A COMPREHENSIVE CONFLICT OF INTEREST POLICY AND INTEREST DISCLOSURE POLICY, AND CAREFULLY AND THOROUGHLY ADMINISTERS THESE POLICIES. BOARD MEMBERS, SPONSORS, SENIOR LEADERS AND KEY CORE LEADERS ARE REQUIRED TO DISCLOSE ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST IN ACCORDANCE WITH THE PROVIDENCE CONFLICT OF INTEREST POLICY, AND SO THAT THE INDIVIDUAL SATISFIES HIS OR HER FIDUCIARY OBLIGATIONS TO THE ORGANIZATION. DISCLOSURES ARE MADE ANNUALLY, AS WELL AS ANY TIME AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST ARISES. PROVIDENCE CHIEF LEGAL OFFICER AND/OR THE PROVIDENCE CHIEF RISK OFFICER, REVIEW ALL DISCLOSURES. WHERE APPROPRIATE, THE CEO AND/OR THE BOARD CHAIR WILL REVIEW CONFLICT OF INTEREST SITUATIONS THAT INVOLVE SENIOR LEADERSHIP OR A BOARD MEMBER OTHER THAN THE CHAIR. PROVIDENCE CHIEF LEGAL OFFICER AND/OR CHIEF RISK OFFICER REVIEW MATTERS WHERE CONFLICT IS DIFFICULT OR CANNOT BE READILY RESOLVED AND PRESENT RECOMMENDATIONS TO THE APPROPRIATE BOARD COMMITTEE OR THE CEO, FOR DISCUSSION AND RESOLUTION. WHEN APPROPRIATE, THE INDIVIDUAL WITH THE REAL/POTENTIAL CONFLICT THAT IS BEING REVIEWED MAY PARTICIPATE IN THE DISCUSSION BUT IS EXCUSED FROM THE MEETING, AND FROM ANY FINAL DISCUSSION AND VOTE, WHEN A DECISION IS BEING MADE ON WHETHER A CONFLICT EXISTS, OR WHEN THE ACTION GIVING RISE TO THE CONFLICT OF INTEREST IS DECIDED. WHERE APPROPRIATE, THE CHIEF RISK OFFICER OR CHIEF LEGAL OFFICER WILL PROVIDE A PLAN TO MANAGE CONFLICTS AND AVOID PARTICIPATION BY THE CONFLICTED INDIVIDUAL IN THE MATTER GIVING RISE TO THE CONFLICT OF INTEREST. AUDITING AND MONITORING OF THIS PROCESS IS DONE PERIODICALLY. ALL DOCUMENTATION OF CONFLICT OF INTEREST DISCLOSURES IS RETAINED IN ACCORDANCE WITH ORGANIZATION RETENTION POLICY.
FORM 990, PART VI, SECTION B, LINE 15	PROCESS FOR DETERMINING COMPENSATION THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/PRESIDENT/EXECUTIVE DIRECTOR IS PAID BY ITS TAX EXEMPT PARENT, PROVIDENCE HEALTH & SERVICES - MONTANA, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. IT IS PROVIDENCE'S INTENTION TO MAKE FINANCIAL INFORMATION ACCESSIBLE AND TRANSPARENT. ALTHOUGH THE FILING OF FORM 990 PROVIDES INSIGHT INTO HOW PROVIDENCE ACHIEVES ITS MISSION, DELIVERS ITS PROGRAMS AND STEWARDS ITS FINANCES, DECIPHERING THE INFORMATION DIRECTLY FROM FORM 990 CAN BE CHALLENGING. THE FOLLOWING PARAGRAPHS PROVIDE FURTHER INFORMATION ABOUT THE PROCESS WE USE TO DETERMINE COMPENSATION FOR TOP MANAGEMENT, OFFICERS AND KEY EMPLOYEES. PROVIDENCE HAS A SINGLE FIDUCIARY BOARD, WITH RESPONSIBILITY FOR FINANCIAL OVERSIGHT ASSOCIATED WITH FULFILLMENT OF THE PROVIDENCE MISSION, DEVELOPING SYSTEM POLICIES, PROTECTING THE ASSETS ENTRUSTED TO THE ORGANIZATION AND OVERSEEING THE STRATEGIC AND OPERATIONAL AFFAIRS OF PROVIDENCE'S LEGAL ENTITIES. PROVIDENCE ALSO MAINTAINS A NETWORK OF COMMUNITY ENTITY BOARDS WITH RESPONSIBILITY FOR QUALITY OF CARE OVERSIGHT, COMMUNITY RELATIONS, ADVOCACY AND COMMUNITY NEEDS ASSESSMENTS. PROVIDENCE HAS A CONSISTENT COMPENSATION PHILOSOPHY FOR ALL OF ITS SENIOR EXECUTIVES, INCLUDING ALL OFFICERS. SALARIES FOR SENIOR EXECUTIVES ARE REVIEWED AT LEAST ANNUALLY BY THE EXECUTIVE COMPENSATION COMMITTEE, WHICH IS A COMMITTEE OF THE PROVIDENCE BOARD CONSISTING ONLY OF OUTSIDE, INDEPENDENT DIRECTORS. THE COMMITTEE MAKES SURE, AT EACH OF ITS MEETINGS, THAT NO MEMBER OF THE COMMITTEE HAS A CONFLICT OF INTEREST AS TO ANY EXECUTIVE WHOSE COMPENSATION IS REVIEWED BY THE COMMITTEE. THE EXECUTIVE COMPENSATION COMMITTEE RETAINS AN INDEPENDENT CONSULTANT EACH YEAR TO REVIEW SALARIES OF THOSE IN THE MOST SIGNIFICANT LEADERSHIP ROLES IN THE ORGANIZATION. PART OF THE CONSULTANT'S ROLE IS TO REVIEW AN EXTENSIVE ARRAY OF COMPENSATION SURVEYS OF LARGE, NOT-FOR-PROFIT HEALTH CARE SYSTEMS IN THE UNITED STATES. PROVIDENCE IS ONE OF THE LARGER HEALTH SYSTEMS IN THE COUNTRY, AND AS SUCH, THE BOARD BENCHMARKS EXECUTIVE COMPENSATION AGAINST OTHER LARGE, NOT-FOR-PROFIT HEALTH SYSTEMS THAT ARE SUBSTANTIALLY SIMILAR TO PROVIDENCE IN SIZE AND COMPLEXITY (SUCH AS HAVING A SIMILAR AMOUNT OF ANNUAL NET REVENUE). ADDITIONALLY, BECAUSE PROVIDENCE OFTEN LOOKS TO GENERAL INDUSTRY FOR LEADERS IN CERTAIN FUNCTIONAL AREAS, PROVIDENCE ALSO TAKES INTO CONSIDERATION GENERAL INDUSTRY MARKET DATA IN THESE SPECIAL SITUATIONS. BASE SALARIES FOR PROVIDENCE EXECUTIVES ARE GENERALLY TARGETED TO THE "MEDIAN" LEVEL OF THE MARKET DATA (WHERE HALF THE SALARIES IN THE DATA ARE LOWER AND HALF THE SALARIES IN THE DATA ARE HIGHER), AS IDENTIFIED BY THE INDEPENDENT CONSULTANT AND REVIEWED WITH THE EXECUTIVE COMPENSATION COMMITTEE. THE PRESIDENT/CEO UTILIZES THE MARKET INFORMATION PROVIDED BY THE CONSULTANT ALONG WITH FORMAL PERFORMANCE EVALUATIONS, TO DETERMINE SALARY RECOMMENDATIONS FOR OTHER SENIOR EXECUTIVES. THIS PROCESS INCLUDES A RIGOROUS ANALYSIS OF THOSE RECOMMENDATIONS WITH THE EXECUTIVE COMPENSATION COMMITTEE AS A PART OF THE REVIEW AND APPROVAL PROCESS. TOTAL COMPENSATION IS TIED CLOSELY TO PERFORMANCE OF THE ORGANIZATION AND THE INDIVIDUAL. PERFORMANCE INCENTIVES ALLOW EXECUTIVES TO EARN ADDITIONAL COMPENSATION IF THEY HELP LEAD PROVIDENCE IN ACHIEVING SPECIFIC ORGANIZATIONAL GOALS FOR FURTHERING PROVIDENCE'S OPERATING COMMITMENTS AND STRATEGIC OBJECTIVES. THE BOARD OF DIRECTORS CONDUCTS A THOROUGH REVIEW PROCESS TO ENSURE PERFORMANCE INCENTIVES ARE ALIGNED WITH APPROPRIATE MARKET PRACTICES. THE BOARD'S PROCESS FOR SETTING, REVIEWING AND APPROVING EXECUTIVE COMPENSATION FULLY COMPLIES WITH IRS STANDARDS (TO ASSURE THAT ALL COMPENSATION IS CONSIDERED REASONABLE) AND REFLECTS BEST GOVERNANCE PRACTICES IN THE INDUSTRY. THE PROCESS WAS LAST COMPLETED IN 2021.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST. THE PROVIDENCE COMMUNITY BENEFIT REPORTS, FINANCIAL REPORTS, CONSOLIDATED AUDITED FINANCIAL STATEMENTS, AND PHILANTHROPY REPORTS ARE ALSO AVAILABLE ON THE PROVIDENCE INTERNET SITE.
FORM 990, PART XI, LINE 9:	UNCOLLECTIBLE PLEDGES -40,625.

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

Cat. No. 51056K

Schedule O (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

ST PATRICK HOSPITAL FOUNDATION

Employer identification number

23-7056976

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?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)COLLABRIA CARE 414 SOUTH JEFFERSON STREET NAPA,CA94559 68-0393144	HEALTHCARE	CA	501(C)(3)	10	SJHCN	Yes
(2)COVENANT ACO 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 61-1573313	HEALTHCARE	TX	501(C)(3)	12, I	CHS	Yes
(3)COVENANT HEALTH NETWORK INC 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 46-1259908	HEALTHCARE	CA	501(C)(3)	12, III	SJHS	Yes
(4)COVENANT HEALTH PARTNERS 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 46-3516417	HEALTHCARE	TX	501(C)(3)	12, I	CHS	Yes
(5)COVENANT HEALTH SYSTEM 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 75-2765566	HEALTHCARE	TX	501(C)(3)	3	SJHS	Yes
(6)COVENANT HEALTH SYSTEM FOUNDATION 3623 22ND PLACE LUBBOCK,TX79410 75-2897026	HEALTHCARE	TX	501(C)(3)	7	CHS	Yes
(7)COVENANT HOSPITAL HOBBS 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 84-4273963	HEALTHCARE	TX	501(C)(3)	3	CHS	Yes
(8)COVENANT MEDICAL CENTER 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 82-2913146	HEALTHCARE	TX	501(C)(3)	3	CHS	Yes
(9)COVENANT MEDICAL GROUP 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 75-2743883	HEALTHCARE	TX	501(C)(3)	3	CHS	Yes
(10)EVERETT TRANSITIONAL CARE SERVICES PO BOX 5128 EVERETT,WA982065128 94-3264605	TRANSITIONAL CARE	WA	501(C)(3)	10	N/A		No
(11)GAMELIN WASHINGTON ASSOCIATION 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 20-1910170	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes
(12)GLOBAL TO LOCAL HEALTH INITIATIVE 2800 SOUTH 192ND ST 104 SEATAC,WA98188 27-3133200	HEALTHCARE	WA	501(C)(3)	7	SHS	Yes
(13)GRACE CLINIC OF LUBBOCK 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 20-3856995	HEALTHCARE	TX	501(C)(3)	3	CHS	Yes
(14)HMTS INC 1 HOAG DRIVE NEWPORT BEACH,CA92658 45-3583707	HEALTHCARE	CA	501(C)(3)	12, I	HMHP	Yes
(15)HOAG CHARITY SPORTS 2081 BUSINESS CENTER DR STE 195 NEWPORT BEACH,CA92663 45-2982422	SUPPORT	CA	501(C)(3)	7	HHF	Yes
(16)HOAG CLINIC 1 HOAG DRIVE NEWPORT BEACH,CA92658 33-0676831	HEALTHCARE	CA	501(C)(3)	10	HMHP	Yes
(17)HOAG HOSPITAL FOUNDATION 330 PLACENTIA AVE NEWPORT BEACH,CA92663 95-3222343	FUNDRAISING	CA	501(C)(3)	7	HMHP	Yes
(18)HOAG MEMORIAL HOSPITAL PRESBYTERIAN 1 HOAG ROAD BOX 6100 NEWPORT BEACH,CA92663 95-1643327	HEALTHCARE	CA	501(C)(3)	3	CHN	Yes
(19)HOSPICE OF LUBBOCK 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 75-2133781	HEALTHCARE	TX	501(C)(3)	10	CHS	Yes
(20)INSTITUTE FOR MENTAL HEALTH & WELLNESS 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 81-4260130	HEALTHCARE	WA	501(C)(3)	PF	PHS SJHS	Yes
(21)INSTITUTE FOR SYSTEMS BIOLOGY 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 91-2003593	HEALTHCARE	WA	501(C)(3)	7	WHC	Yes
(22)KADLEC AUXILIARY INC 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 91-6033089	SUPPORT	WA	501(C)(3)	12, III	KRMC	Yes
(23)KADLEC FOUNDATION 888 SWIFT BLVD RICHLAND,WA99352 23-7005501	SUPPORT	WA	501(C)(3)	7	KRMC	Yes
(24)KADLEC REGIONAL MEDICAL CENTER 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 91-0655392	HEALTHCARE	WA	501(C)(3)	3	WHC	Yes
(25)LITTLE COMPANY OF MARY ANCILLARY SERVICES CORPORATION 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 33-0844408	IMAGING SERVICES	CA	501(C)(3)	10	PHS SOCAL	Yes
(26)LUBBOCK HERITAGE HOSPITAL LLC 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 26-4021016	HEALTHCARE	TX	501(C)(3)	3	CHS	Yes
(27)LUNDBERG ASSOCIATION PROVIDENCE HOUSE 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 91-1562797	SUPPORT	OR	501(C)(3)	7	PHS OR	Yes
(28)METHODIST CHILDREN'S HOSPITAL 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 75-2428911	HEALTHCARE	TX	501(C)(3)	3	CHS	Yes
(29)METHODIST HOSPITAL LEVELLAND 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 75-2246348	HEALTHCARE	TX	501(C)(3)	3	CHS	Yes
(30)METHODIST HOSPITAL PLAINVIEW 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 75-2426010	HEALTHCARE	TX	501(C)(3)	3	CHS	Yes
(31)MISSION HOSPITAL REGIONAL MEDICAL CTR 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 95-1643360	HEALTHCARE	CA	501(C)(3)	3	CHN	Yes
(32)NORTHWEST HOPE & HEALING FOUNDATION PO BOX 16069 SEATTLE,WA98116 20-0799737	SUPPORT	WA	501(C)(3)	12, I	SHS	Yes
(33)OPEN DOOR VENTURES 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 91-1608508	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes
(34)PACMED CLINICS 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 56-2290878	HEALTHCARE	WA	501(C)(3)	10	WHC	Yes
(35)PH&S FOUNDATIONSFVSA & SCVSA 501 SOUTH BUENA VISTA STREET BURBANK,CA915054809 95-3544877	HEALTHCARE	CA	501(C)(3)	7	PHS SOCAL	Yes
(36)PROVIDENCE ALASKA FOUNDATION 3760 PIPER STREET SUITE 2021 ANCHORAGE,AK99508 92-0093565	HEALTHCARE	AK	501(C)(3)	7	PHS WA	Yes
(37)PROVIDENCE BENEDICTINE NURSING CENTER FOUNDATION 540 SOUTH MAIN ST MT ANGEL,OR97362 91-1940286	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes
(38)PROVIDENCE BLANCHET ASSOCIATION 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 91-1789266	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes
(39)PROVIDENCE CHILDREN'S HEALTH FOUNDATION 4805 NE GLISAN ST STE 2N35 PORTLAND,OR97213 93-0800140	SUPPORT	OR	501(C)(3)	7	PHS OR	Yes
(40)PROVIDENCE COMMUNITY HEALTH FOUNDATION 940 ROYAL AVE SUITE 410 MEDFORD,OR97504 93-0692907	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes
(41)PROVIDENCE DETHMAN HOUSE 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 47-3385506	SUPPORT	WA	501(C)(3)	7	N/A		No
(42)PROVIDENCE FACEY MEDICAL FOUNDATION (FKA FACEY MEDICAL FDN) 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 95-4322584	SUPPORT	CA	501(C)(3)	7	PHS SOCAL	Yes
(43)PROVIDENCE GAMELIN HOUSE ASSOCIATION 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 31-1744654	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes
(44)PROVIDENCE HEALTH & SERVICES 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 91-1549796	HEALTHCARE	WA	501(C)(3)	12, II	PSJH		No
(45)PROVIDENCE HEALTH & SERVICES - MONTANA 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 81-0231793	HEALTHCARE	MT	501(C)(3)	3	PHS WA	Yes
(46)PROVIDENCE HEALTH & SERVICES - OREGON 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 51-0216587	HEALTHCARE	OR	501(C)(3)	3	PHS	Yes
(47)PROVIDENCE HEALTH & SERVICES - WASHINGTON 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 51-0216586	HEALTHCARE	WA	501(C)(3)	3	PHS	Yes
(48)PROVIDENCE HEALTH & SERVICES - WESTERN WASHINGTON 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 91-1303277	HEALTHCARE	WA	501(C)(3)	3	PMWHC	Yes
(49)PROVIDENCE HEALTH ASSURANCE 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 55-0828701	MEDICAID HEALTHCARE PROVIDER	OR	501(C)(4)	N/A	PHP	Yes
(50)PROVIDENCE HEALTH CARE FOUNDATION - EASTERN WASHINGTON 101 W 8TH AVE SPOKANE,WA99204 32-0014330	HEALTHCARE	WA	501(C)(3)	7	PHS WA	Yes
(51)PROVIDENCE HEALTH PLAN 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 93-0863097	HEALTHCARE	OR	501(C)(4)	N/A	PPP	Yes
(52)PROVIDENCE HEALTH SYSTEM - SO CALIFORNIA 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 51-0216589	HEALTHCARE	CA	501(C)(3)	3	PHS	Yes
(53)PROVIDENCE HOOD RIVER MEMORIAL HOSPITAL FOUNDATION INC 810 12TH STREET PO BOX 149 HOOD RIVER,OR97031 93-0921990	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes
(54)PROVIDENCE HOSPICE AND HOME CARE FOUNDATION SNOHOMISH COUNTY 1615 75TH ST SW SUITE 210 EVERETT,WA98203 27-2552749	HEALTHCARE	WA	501(C)(3)	7	PHS W WA	Yes
(55)PROVIDENCE HOSPICE OF SEATTLE FOUNDATION 2811 SOUTH 102ND NO 220 TUKWILA,WA98168 91-2077378	HEALTHCARE	WA	501(C)(3)	7	PHS W WA	Yes
(56)PROVIDENCE LITTLE COMPANY OF MARY FOUNDATION 4101 TORRANCE BLVD TORRANCE,CA90503 51-0224944	HEALTHCARE	CA	501(C)(3)	7	PHS SOCAL	Yes
(57)PROVIDENCE MARIANWOOD FOUNDATION 3725 PROVIDENCE POINT DRIVE SE ISSAQUAH,WA980297219 93-1554288	HEALTHCARE	WA	501(C)(3)	7	PHS W WA	Yes
(58)PROVIDENCE MEDICAL FDN (FKA ST JOSEPH HERITAGE HEALTHCARE) 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 33-0185031	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes
(59)PROVIDENCE MEDICAL INSTITUTE 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 33-0283773	HEALTHCARE	CA	501(C)(3)	12, I	PHS SOCAL	Yes
(60)PROVIDENCE MILWAUKIE FOUNDATION 10150 SE 32ND AVE MILWAUKIE,OR97222 94-3079515	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes
(61)PROVIDENCE MINISTRIES 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057	RELIGIOUS ORG	WA	501(C)(3)	1	N/A		No
(62)PROVIDENCE MOUNT ST VINCENT FOUNDATION 4831 35TH AVE SW SEATTLE,WA981262799 91-1188119	HEALTHCARE	WA	501(C)(3)	7	PHS WA	Yes
(63)PROVIDENCE NEWBERG HEALTH FOUNDATION 1001 PROVIDENCE DRIVE NEWBERG,OR97132 93-0889144	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes
(64)PROVIDENCE PETER CLAVER ASSOCIATION 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 31-1629656	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes
(65)PROVIDENCE PLAN PARTNERS 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 91-1861964	HEALTHCARE	WA	501(C)(4)	N/A	PHS OR	Yes
(66)PROVIDENCE PORTLAND MEDICAL FOUNDATION 4805 NE GLISAN ST PORTLAND,OR972132967 93-1231494	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes
(67)PROVIDENCE ROSSI ASSOCIATION 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 31-1584166	SUPPORT	WA	501(C)(3)	10	PHS WA	Yes
(68)PROVIDENCE SAINT JOHN'S HEALTH CENTER 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 95-1684082	HEALTHCARE	CA	501(C)(3)	3	PHS SOCAL	Yes
(69)PROVIDENCE SAINT JOHN'S MEDICAL FOUNDATION 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 81-4542216	HEALTHCARE	CA	501(C)(3)	3	PHS SOCAL	Yes
(70)PROVIDENCE SEASIDE HOSPITAL FOUNDATION 725 S WAHANNA ROAD SEASIDE,OR97138 93-0927320	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes
(71)PROVIDENCE SW WASHINGTON FOUNDATION (FKA PROV ST PETER FDN) 413 LILLY ROAD NE OLYMPIA,WA985065166 91-1097056	SUPPORT	WA	501(C)(3)	7	PHS W WA	Yes
(72)PROVIDENCE ST ELIZABETH HOUSE ASSOCIATION 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 91-2171539	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes
(73)PROVIDENCE ST FRANCIS ASSOCIATION 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 94-3244854	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes
(74)PROVIDENCE ST JOSEPH HEALTH 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 81-1244422	HEALTHCARE	WA	501(C)(3)	12, III	N/A		No
(75)PROVIDENCE ST JOSEPH HEALTH FOUNDATION 4400 NE HALSEY ST STE 599 PORTLAND,OR97213 94-3078543	HEALTHCARE	WA	501(C)(3)	7	PHS WA	Yes
(76)PROVIDENCE ST JOSEPH MEDICAL CENTER 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 81-0463482	HEALTHCARE	MT	501(C)(3)	3	PHS WA	Yes
(77)PROVIDENCE ST MARY FOUNDATION 401 W POPLAR STREET WALLA WALLA,WA99362 45-2841492	HEALTHCARE	WA	501(C)(3)	7	PHS WA	Yes
(78)PROVIDENCE ST VINCENT MEDICAL FOUNDATION 9205 SW BARNES ROAD STE MT2111 PORTLAND,OR97225 93-0575982	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes
(79)PROVIDENCE TRINITYCARE HOSPICE 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 95-3264139	HEALTHCARE	CA	501(C)(3)	10	PHS SOCAL	Yes
(80)PROVIDENCE TRINITYCARE HOSPICE FOUNDATION 5315 TORRANCE BLVD NO B-1 TORRANCE,CA90503 33-0261016	HEALTHCARE	CA	501(C)(3)	7	PTCH	Yes
(81)PROVIDENCE WILLAMETTE FALLS MEDICAL FOUNDATION 1500 DIVISION STREET OREGON CITY,OR97045 93-1003750	HEALTHCARE	OR	501(C)(3)	12, I	PHS OR	Yes
(82)REDWOOD MEMORIAL FOUNDATION 2700 DOBEER STREET EUREKA,CA95501 94-2779313	HEALTHCARE	CA	501(C)(3)	7	SJHNC LLC	Yes
(83)SAINT JOHN'S CANCER INSTITUTE (FKA JOHN WAYNE CANCER INST) 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 95-4291515	HEALTHCARE	CA	501(C)(3)	4	PSJHC	Yes
(84)SAINT JOHN'S HOSPITALHEALTH CENTER FOUNDATION 2121 SANTA MONICA BLVD SANTA MONICA,CA90404 95-6100079	SUPPORT SAINT JOHN HEALTH CENTER & JWCI	CA	501(C)(3)	7	PSJHC	Yes
(85)SEATTLE SCIENCE FOUNDATION 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 61-1502822	PHYSICIAN COLLABORATION	WA	501(C)(3)	7	WHC	Yes
(86)SISTERS OF PROVIDENCE OF MONTANA CORPORATION 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 26-2612415	SHELL CORPORATION	MT	501(C)(3)	1	PHS WA		No
(87)SISTERS OF ST JOSEPH OF ORANGE 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 95-1643383	RELIGIOUS ORG	CA	501(C)(3)	1	N/A		No
(88)SRM ALLIANCE HOSPITAL SERVICES (PVH) 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 68-0395200	HEALTHCARE	CA	501(C)(3)	3	SJHNC LLC	Yes
(89)ST JOSEPH HEALTH MINISTRY 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 27-1666576	RELIGIOUS ORG	CA	501(C)(3)	1	SSJO		No
(90)ST JOSEPH HEALTH NORTHERN CALIFORNIA LLC 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 81-4791043	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes
(91)ST JOSEPH HEALTH SYSTEM 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 95-3589356	HEALTHCARE	CA	501(C)(3)	12, I	PSJH		No
(92)ST JOSEPH HEALTH SYSTEM FOUNDATION 3345 MICHELSON DRIVE SUITE 100 IRVINE,CA92612 33-0143024	HEALTHCARE	CA	501(C)(3)	10	SJHS	Yes
(93)ST JOSEPH HOME CARE NETWORK 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 68-0331084	HEALTHCARE	CA	501(C)(3)	10	SJHS	Yes
(94)ST JOSEPH HOSPITAL OF ORANGE 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 95-1643359	HEALTHCARE	CA	501(C)(3)	3	CHN	Yes
(95)ST JUDE HOSPITAL INC 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 95-1643325	HEALTHCARE	CA	501(C)(3)	3	CHN	Yes
(96)ST LUKE ASSOCIATION 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 94-3176618	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes
(97)ST MARY MEDICAL CENTER 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 95-1914489	HEALTHCARE	CA	501(C)(3)	3	CHN	Yes
(98)ST THOMAS CHILD AND FAMILY CENTER 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 81-0233495	EDUCATION	MT	501(C)(3)	10	PHS WA	Yes
(99)SWEDISH EDMONDS 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 27-2305304	HEALTHCARE	WA	501(C)(3)	3	WHC	Yes
(100)SWEDISH HEALTH SERVICES 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 91-0433740	HEALTHCARE	WA	501(C)(3)	3	WHC	Yes
(101)SWEDISH MEDICAL CENTER FOUNDATION 747 BROADWAY SEATTLE,WA98122 91-0983214	HEALTHCARE	WA	501(C)(3)	7	SHS	Yes
(102)SWEDISH MJM HOLDINGS 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 27-3139262	HOLDING COMPANY	WA	501(C)(3)	12, I	SHS	Yes
(103)TARZANA MEDICAL CENTER LLC 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 83-3972614	HEALTHCARE	CA	501(C)(3)	3	PHS SOCAL	Yes
(104)THE GAMELIN ASSOCIATION 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 91-1180824	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes
(105)THE GAMELIN CALIFORNIA ASSOCIATION 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 91-1293869	SUPPORT	CA	501(C)(3)	10	PHS SOCAL	Yes
(106)THE GAMELIN OREGON ASSOCIATION 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 91-1214491	SUPPORT	OR	501(C)(3)	10	PHS OR	Yes
(107)TRI-CITIES CANCER CENTER 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 91-1594526	HEALTHCARE	WA	501(C)(3)	3	KRMC	Yes
(108)TRI-CITIES CANCER CENTER FOUNDATION 7350 W DESCHUTES AVE BUILDING A KENNEWICK,WA99336 91-1739024	SUPPORT	WA	501(C)(3)	7	KRMC	Yes
(109)UNIVERSITY OF PROVIDENCE 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 81-0231777	EDUCATION	MT	501(C)(3)	2	PHS	Yes
(110)WESTERN HEALTHCONNECT 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 45-4171900	SHELL CORPORATION	WA	501(C)(3)	12, II	PHS W WA	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2021

Page 2

Part III

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) 20TH STREET SURGERY LLC 1301 20TH STREET STE 140 SANTA MONICA,CA90404 73-1735618	AMBULATORY SURGERY CENTER	CA	N/A				No			No
(2) BRIDGEPORT MEDICAL IMAGING LLC (BMI) 4400 NE HALSEY 495 PORTLAND,OR97213 26-0796953	IMAGING - DIAGNOSTICS	OR	N/A				No		Yes
(3) BROADWAY IMAGING LLC PO BOX 4587 MISSOULA,MT598064587 52-2405971	MEDICAL IMAGING	MT	N/A				No		Yes
(4) CANBY MEDICAL CENTER I LLC 4800 SW MACADAM AVE STE 120 PORTLAND,OR97239 20-5470937	REAL ESTATE - MOB	OR	N/A				No		Yes
(5) CENTER FOR MATERNAL NEWBORN AND CHILD HEALTH LLC 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 81-3526875	HEALTHCARE	CA	N/A				No			No
(6) CENTER FOR MEDICAL IMAGING LLC (CMI) 4400 NE HALSEY 495 PORTLAND,OR97213 20-0477972	IMAGING - DIAGNOSTICS	OR	N/A				No		Yes
(7) CLACKAMAS RADIATION ONCOLOGY CENTER LLC 4400 NE HALSEY 495 PORTLAND,OR97213 26-0381897	RADIATION ONCOLOGY	OR	N/A				No		Yes
(8) COASTAL ASC HOLDINGS LLC ONE HOAG DRIVE BOX 6100 NEWPORT BEACH,CA92663 81-0986844	HEALTHCARE	CA	N/A				No		Yes
(9) COMPREHENSIVE IMAGING PARTNERS OF ORANGE COUNTY ONE CITY BLVD W STE 1100 ORANGE,CA92868 26-4591502	HEALTHCARE	CA	N/A				No		Yes
(10) COVENANT LONG-TERM CARE LP 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 20-5033419	HEALTHCARE	TX	N/A				No			No
(11) CSS JV LLC 11782 SW BARNES ROAD STE 200 BLDG C PORTLAND,OR97225 26-3638838	AMBULATORY SURGERY CENTER	OR	N/A				No			No
(12) FIRST HILL SURGERY CENTER LLC 1101 MADISON STREET STE 200 SEATTLE,WA98104 47-2066485	AMBULATORY SURGERY CENTER	WA	N/A				No		Yes
(13) FULLERTON SURGICAL CENTER LP 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 47-0927394	AMBULATORY SURGERY CENTER	CA	N/A				No		Yes
(14) GREATER VALLEY MEDICAL BUILDING LP 501 S BUENA VISTA ST BURBANK,CA91505 95-4570858	REAL ESTATE - MOB	CA	N/A				No			No
(15) HCSA PROPERTIES LLC 1600 M STREET NW AUBURN,WA98001 46-0620892	REAL ESTATE RENTAL	WA	N/A				No			No
(16) HERITAGE INVESTMENT GROUP I LLC 500 S MAIN STREET STE 1000 ORANGE,CA92868 27-1000061	INVESTMENTS	CA	N/A				No			No
(17) HOAG ORTHOPEDIC INSTITUTE 1 HOAG DRIVE BOX 6100 NEWPORT BEACH,CA92658 61-1588294	HEALTHCARE	CA	N/A				No		Yes
(18) IMAGING ASSOCIATES LLC 3650 PIPER STREET STE A ANCHORAGE,AK99508 20-3906048	MEDICAL IMAGING	AK	N/A				No		Yes
(19) INLAND IMAGING LLC 801 S STEVENS ST SPOKANE,WA99204 91-1855796	MEDICAL IMAGING	WA	N/A				No		Yes
(20) LSC REAL PROPERTY LLC 2301 QUAKER AVENUE LUBBOCK,TX79410 47-4646059	REAL ESTATE	TX	N/A				No			No
(21) METHODIST DIAGNOSTIC IMAGING 4005 24TH STREET LUBBOCK,TX79410 75-2343261	HEALTHCARE	TX	N/A				No			No
(22) MISSION VIEJO PARTNERS II LLC 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 82-3943675	REAL ESTATE - MOB	CA	N/A				No		Yes
(23) NEWPORT IMAGING CENTER 360 SN MIGUEL NEWPORT BEACH,CA92660 33-0191776	HEALTHCARE	CA	N/A				No		Yes
(24) NORTH OC IMAGING JV HOLDINGS LLC 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 85-2444305	HEALTHCARE	CA	N/A				No			No
(25) OREGON ADVANCED IMAGING LLC 881 OHARE PARKWAY MEDFORD,OR97504 45-0471748	MEDICAL IMAGING	OR	N/A				No		Yes
(26) OREGON OUTPATIENT SURGERY CENTER 7300 SW CHILDS RD TIGARD,OR97224 22-3883387	AMBULATORY SURGERY CENTER	OR	N/A				No			No
(27) PETCT IMAGING AT SWEDISH CANCER INSTITUTE LLC 1221 MADISON STREET SEATTLE,WA98104 20-3132044	MEDICAL IMAGING	WA	N/A				No		Yes
(28) PERFORMANCE MEDICAL EQUIPMENT & RESPIRATORY SERVICES LLC 19625 62ND AVENUE SOUTH SUITE 101 KENT,WA98032 45-2901632	MEDICAL EQUIPMENT	WA	N/A				No		Yes
(29) PHS INVESTMENT TRUST SHORT TERM INVESTMENT PORTFOLIO 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 81-2701056	INVESTMENTS	WA	N/A				No			No
(30) PROV RADIATION ONCOLOGY DEVELOP ASSN LLC 4400 NE HALSEY 495 PORTLAND,OR97213 26-0682491	REAL ESTATE - MOB	OR	N/A				No			No
(31) PROVIDENCE & SCA OFF-CAMPUS HOLDINGS LLC 569 BROOKWOOD VILLAGE SUITE 901 BIRMINGHAM,AL35209 82-3765555	MEDICAL	AL	N/A				No			No
(32) PROVIDENCE & SCA ON-CAMPUS HOLDINGS LLC 569 BROOKWOOD VILLAGE SUITE 901 BIRMINGHAM,AL35209 82-3270499	MEDICAL	AL	N/A				No		Yes
(33) PROVIDENCE CHILDREN'S NEONATAL SVCS 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 47-0918549	NEONATAL CARE	WA	N/A				No			No
(34) PROVIDENCE IMAGING CENTER JOINT VENTURE 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 92-0118807	MEDICAL IMAGING	AK	N/A				No			No
(35) PROVIDENCE ST JOSEPH HEALTH LONG TERM PORTFOLIO 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 82-3190634	INVESTMENTS	WA	N/A				No			No
(36) PROVIDENCE SURGERY CENTER LLC 902 N ORANGE ST MISSOULA,MT59802 84-1401625	AMBULATORY SURGERY CENTER	MT	N/A				No			No
(37) PROVIDENCE UCLA USP SURGERY CENTER JV 14201 DALLAS PARKWAY DALLAS,TX75254 32-0503030	AMBULATORY SURGERY CENTER	CA	N/A				No			No
(38) PROVIDENCEUSP SOUTH BAY SURGERY CENTERS 15305 DALLAS PKWY STE 1600 LB 28 ADDISON,TX75001 47-5064486	AMBULATORY SURGERY CENTER	CA	N/A				No			No
(39) PROVIDENCEUSP SURGERY CTRS LLC 11550 INDIAN HILLS ROAD 160 MISSION HILLS,CA91345 20-0684116	AMBULATORY SURGERY CENTER	CA	N/A				No			No
(40) RADIATION THERAPY INNOVATIONS LLC 1221 MADISON ST 1ST FL SEATTLE,WA98104 30-0553035	HEALTHCARE	WA	N/A				No		Yes
(41) SANTA ANA MOB LLC 1800 QUAIL STREET STE 100 NEWPORT BEACH,CA92660 75-3205306	REAL ESTATE - MOB	CA	N/A				No		Yes
(42) SJO ASC HOLDINGS LLC 1140 W LA VETA AVE ORANGE,CA92868 82-1655501	HEALTHCARE	CA	N/A				No			No
(43) ST JOSEPH PHYSICIAN VENTURES I LLC 1100 WEST STEWART DRIVE ORANGE,CA92868 45-4521884	REAL ESTATE	CA	N/A				No		Yes
(44) ST JOSEPHSATELLITE DIALYSIS CENTERS LLC 300 SANTANA ROW SUITE 300 SAN JOSE,CA95128 81-4657391	HEALTHCARE	CA	N/A				No			No
(45) ST JUDE SURGICAL CENTERS LLC 1801 LIND AVENUE SW ATTN TAX DEPT RENTON,WA98057 82-3352570	AMBULATORY SURGERY CENTER	CA	N/A				No		Yes
(46) ST PETER-SOUTH SOUND REGIONAL MRI CENTER 3417 ENSIGN RD NE OLYMPIA,WA98506 91-1455338	MEDICAL IMAGING	WA	N/A				No		Yes
(47) SURGERY CENTER AT TANASBOURNE LLC 11221 ROE AVE STE 300 LEAWOOD,KS66211 20-8187971	AMBULATORY SURGERY CENTER	KS	N/A				No		Yes
(48) TARZANA PEDIATRIC VENTURES LLC 18321 CLARK ST TARZANA,CA91356 82-1308306	HEALTHCARE	CA	N/A				No			No
(49) THE MADISON SPOKANE INN LLC 15 WEST ROCKWOOD BLVD SPOKANE,WA99204 84-1606484	HOTEL SERVICES	WA	N/A				No		Yes
(50) WON-ONC LLC 1900 COOKS HILL RD CENTRALIA,WA98531 26-2181194	REAL ESTATE - MOB	WA	N/A				No		Yes

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?
(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	Yes	No
(1) 1221 MADISON STREET OWNERS ASSOC 747 BROADWAY SEATTLE,WA98122 20-1954319	OWNERS' ASSOCIATION	WA	N/A	C					No
(2) ACCLARA SOLUTIONS GROUP LLC 10713 W SAM HOUSTON PKWY N 500 HOUSTON,TX77064 87-0837184	HOLDING COMPANY	TX	N/A	C					No
(3) ACCLARA SOLUTIONS INTERMEDIATE LLC 10713 W SAM HOUSTON PKWY N 500 HOUSTON,TX77064 37-1783298	HEALTHCARE FINANCIAL SERVICES	TX	N/A	C					No
(4) AMERICAN UNITY GROUP LTD 90 PITTS BAY ROAD HM08 PEMBROKE BD	CAPTIVE INSURANCE	BD	N/A	C					No
(5) AYIN HEALTH SOLUTIONS INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 83-3037172	HEALTHCARE	DE	N/A	C					No
(6) BOURGET HEALTH SERVICES INC 101 W 8TH AVE TAF C-9 SPOKANE,WA99204 91-1354431	CLINICAL/MEDICAL LAB	WA	N/A	C					No
(7) CARON CORPORATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 81-0486082	MEDICAL PHYSICIAN SERVICE	MT	N/A	C					No
(8) COLBURN HILL GROUP INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA95057 86-3383433	HEALTHCARE	DE	N/A	C					No
(9) COMMUNITY TECHNOLOGIES INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 84-4722399	IT SVCS	DE	N/A	C					No
(10) ENDOSCOPY CENTER OF SOUTHERN CALIFORNIA 1301 20TH ST STE 280 SANTA MONICA,CA90404 95-2880495	HEALTHCARE	CA	N/A	S					No
(11) HMR WEIGHT MANAGEMENT SERVICES CORP 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 46-3598718	HEALTHCARE	WA	N/A	C					No
(12) HOAG MANAGEMENT SERVICES INC 1 HOAG DRIVE BOX 6100 NEWPORT BEACH,CA92658 33-0731587	HEALTHCARE	CA	N/A	C					No
(13) HOAG PHYSICIAN PARTNERS 16148 SAND CANYON AVE IRVINE,CA92618 83-4276044	HEALTHCARE	CA	N/A	C					No
(14) KENSCI INC 615 2ND AVE 700 SEATTLE,WA98104 47-4048082	HEALTHCARE	WA	N/A	C					No
(15) KENSCI TECH INDIA PRIVATE LIMITED 615 2ND AVE 700 SEATTLE,WA98104	HEALTHCARE	IN	N/A	C					No
(16) KENSCI ASIA PACIFIC PTE LTD 615 2ND AVE 700 SEATTLE,WA98104	HEALTHCARE	SN	N/A	C					No
(17) LUBBOCK METHODIST HOSP PRACTICE MGMT 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 75-2578995	INACTIVE	TX	N/A	C					No
(18) LUBBOCK METHODIST HOSPITAL SVCS 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 75-2118585	HEALTHCARE	TX	N/A	C					No
(19) LUMEDIC INC (FKA LUMEDIC ACQ CO INC) 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 83-3881097	HEALTHCARE	WA	N/A	C					No
(20) MEDICAL SPECIALTIES MANAGERS INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 33-0406218	HEALTHCARE	WA	N/A	C					No
(21) MEDIREVV INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 20-8783763	HEALTHCARE	DE	N/A	C					No
(22) MISSION VIEJO MEDICAL VENTURES INC 27800 MEDICAL CENTER RD 354 MISSION VIEJO,CA92691 33-0212905	HEALTHCARE	CA	N/A	C					No
(23) PERFORMANCE HEALTH TECHNOLOGY LTD 3993 FAIRVIEW INDUSTRIAL DR SE SALEM,OR97302 93-1211733	HEALTHCARE	OR	N/A	C					No
(24) PHN HOLDINGS 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 46-1814184	STRATEGIC PLANNING SERVICES	CA	N/A	C					No
(25) PIONEER INNOVATIONS INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 36-4818191	HEALTHCARE INNOVATIONS	WA	N/A	C					No
(26) PROVIDENCE ASSURANCE INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 20-8194071	CAPTIVE INSURANCE	AZ	N/A	C					No
(27) PROVIDENCE GLOBAL CENTER LLP 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 98-1516461	IT SVCS	IN	N/A	C					No
(28) PROVIDENCE HEALTH CARE VENTURES INC 101 W 8TH AVE TAF C-9 SPOKANE,WA99204 90-0155714	CLINICAL/MEDICAL LAB	WA	N/A	C					No
(29) PROVIDENCE HEALTH NETWORK 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 80-0886966	PREPAID HEALTHCARE	CA	N/A	C					No
(30) PROVIDENCE HEALTH VENTURES INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 33-0122216	INVESTMENT	CA	N/A	C					No
(31) PROVIDENCE PHYSICIAN SERVICES CO 101 W 8TH AVE TAF C-9 SPOKANE,WA99204 91-1216033	HEALTHCARE	WA	N/A	C					No
(32) PROVIDENCE ST JOSEPH HEALTH NETWORK 20555 EARL ST TORRANCE,CA90503 82-3771547	HEALTHCARE	CA	N/A	C					No
(33) QUIVIQ INC 1400-112TH AVENUE ST SUITE 100 BELLEVUE,WA98004 83-3879444	HEALTHCARE ANALYTICS	WA	N/A	C					No
(34) ST JOSEPH HEALTH 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 46-2340232	HOLDING COMPANY	CA	N/A	C					No
(35) ST JOSEPH HEALTH SOURCE INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 46-1900168	HEALTHCARE	CA	N/A	C					No
(36) ST JOSEPH PROF SVCS ENTERPRSES INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 33-0155323	HEALTHCARE	CA	N/A	C					No
(37) TEGRIA HOLDINGS LLC (FKA GRADY BLOCKER LLC) 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 84-2092143	HOLDING COMPANY	DE	N/A	C					No
(38) TEGRIA INSIGHTS GROUP HOLDINGS INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 86-1400769	HOLDING COMPANY	WA	N/A	C					No
(39) TEGRIA INSIGHTS GROUP INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 86-1532593	HEALTHCARE	WA	N/A	C					No
(40) TEGRIA PRODUCTS GROUP INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 87-0995138	HOLDING COMPANY	DE	N/A	C					No
(41) TEGRIA RCM GROUP INC (FKA PROV RCM GROUP INC) 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 84-4686520	HOLDING COMPANY	DE	N/A	C					No
(42) TEGRIA RCM GROUP US INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 86-3046450	HOLDING COMPANY	DE	N/A	C					No
(43) TEGRIA SERVICES GROUP-CAN INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057	HEALTHCARE	CA	N/A	C					No
(44) TEGRIA SERVICES GROUP INC (FKA PROVIDENCE SERVICES GROUP) 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 84-4704409	HOLDING COMPANY	DE	N/A	C					No
(45) TEGRIA SERVICES GROUP-US INC (FKA BLUETREE NETWORK INC) 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 90-0872936	HEALTHCARE	WI	N/A	C					No
(46) VINSERRA INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 95-3943315	INVESTMENT	CA	N/A	C					No
(47) CHARITABLE REMAINDER TRUST (1)	TRUST	WA	N/A	T					No

Schedule R (Form 990) 2021

Page 3

Part V

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

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

Yes

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

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

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

Yes

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

Yes

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

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

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

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

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

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

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

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

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

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

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

Yes

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

Yes

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

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

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

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

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

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) PROVIDENCE HEALTH & SERVICES - MONTANA	B	10,124,014	COST
(2) PROVIDENCE ST JOSEPH MEDICAL CENTER	B	511,432	COST
(3) PROVIDENCE HEALTH & SERVICES - MONTANA	C	808,106	COST

Schedule R (Form 990) 2021

Page 4

Part VI

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

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

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

Schedule R (Form 990) 2021

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) 2021

Additional Data

Software ID:
Software Version:

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	5,128,682	5,473,674
9	Program service revenue (Part VIII, line 2g) .........	24,253	57,652
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	585,694	1,050,286
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	0	0
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	5,738,629	6,581,612
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	1,437,288	11,471,219
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	697,747	764,245
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	196,710	110,000
b	Total fundraising expenses (Part IX, column (D), line 25) 755,383
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	312,094	301,119
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	2,643,839	12,646,583
19	Revenue less expenses. Subtract line 18 from line 12.......	3,094,790	-6,064,971
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	34,223,753	38,164,577
21	Total liabilities (Part X, line 26).............	7,063,435	17,978,651
22	Net assets or fund balances. Subtract line 21 from line 20.....	27,160,318	20,185,926

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 11,471,219 including grants of $ 11,471,219 ) (Revenue $ 57,652 )
	SEE SCHEDULE OAT PROVIDENCE, WE USE OUR VOICE TO ADVOCATE FOR VULNERABLE POPULATIONS AND NEEDED REFORMS IN HEALTH CARE. WE PURSUE INNOVATIVE WAYS TO TRANSFORM HEALTH CARE BY KEEPING PEOPLE HEALTHY, AND MAKING OUR SERVICES MORE CONVENIENT, ACCESSIBLE AND AFFORDABLE FOR ALL. IN AN INCREASINGLY UNCERTAIN WORLD, WE ARE COMMITTED TO HIGH-QUALITY, COMPASSIONATE CARE FOR EVERYONE - REGARDLESS OF COVERAGE OR ABILITY TO PAY. WE HELP PEOPLE AND COMMUNITIES BENEFIT FROM THE BEST HEALTH CARE MODEL FOR THE FUTURE - TODAY.TOGETHER, OUR 120,000 CAREGIVERS (ALL EMPLOYEES) SERVE IN 52 HOSPITALS, 1,085 CLINICS AND A COMPREHENSIVE RANGE OF SERVICES ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. THE PROVIDENCE FAMILY INCLUDES:-PROVIDENCE ACROSS SEVEN WESTERN STATES-COVENANT HEALTH IN WEST TEXAS-PROVIDENCE FACEY MEDICAL FOUNDATION IN LOS ANGELES, CA-HOAG MEMORIAL HOSPITAL PRESBYTERIAN IN ORANGE COUNTY, CA-KADLEC IN SOUTHEAST WASHINGTON-PACIFIC MEDICAL CENTERS IN SEATTLE, WA-SWEDISH HEALTH SERVICES IN SEATTLE, WA2021 WAS MARKED BY THREE MAJOR SURGES IN COVID-19 VOLUMES, A NATIONAL SHORTAGE OF HEALTH CARE PERSONNEL, AS WELL AS DEFERRALS OF NON-EMERGENT CARE. EVEN WITH THESE TREMENDOUS CHALLENGES, THE PROVIDENCE FAMILY OF ORGANIZATIONS CONTINUED TO INVEST IN OUR COMMUNITIES, GUIDED BY OUR STRATEGIC PLAN AND OUR COMMUNITY BENEFIT PRIORITIES.FOR MORE INFORMATION GO TO: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT ENVIRONMENTAL, SOCIAL, AND GOVERNANCE STANDARDSOVER THE LAST TWO YEARS, PROVIDENCE ADVANCED A SOCIAL RESPONSIBILITY FRAMEWORK THAT INCLUDES A STRONGER COMMITMENT TO DIVERSITY, EQUITY, INCLUSION, AND ENVIRONMENTAL STEWARDSHIP. WE UPDATED OUR INTEGRATED STRATEGIC & FINANCIAL PLAN TO MORE CLEARLY EXPRESS OUR COMMITMENT AND ACCELERATION OF THIS IMPORTANT WORK TO ADDRESS SOCIAL, RACIAL, AND ECONOMIC DISPARITIES IN THE COMMUNITIES WE SERVE. PROVIDENCE'S SOCIAL RESPONSIBILITY FRAMEWORK AIMS TO DEPLOY THE ASSETS OF OUR SYSTEM TO SUPPORT COMMUNITY HEALTH IMPROVEMENT, STRENGTHEN LOCAL ECONOMIES AND REDUCE OUR CARBON FOOTPRINT. IN 2021, OUR SUSTAINABLE AND INCLUSIVE PURCHASING PROGRAM COMMITTED TO INCREASE OUR SPEND WITH WOMEN AND MINORITY OWNED BUSINESS ENTERPRISES BY OVER $300 MILLION ACROSS THE NEXT FIVE YEARS. WE ALSO DEPLOY AN INVESTING PORTFOLIO WHICH INCLUDES SHAREHOLDER ADVOCACY, IMPACT INVESTING, AND SOCIALLY CONSCIOUS PORTFOLIO SCREENS. IN 2021, PROVIDENCE MADE PROGRESS TOWARDS ITS CLIMATE COMMITMENT TO BECOME CARBON NEGATIVE BY 2030. WE ARE IMPLEMENTING AN ENVIRONMENTAL STEWARDSHIP SYSTEM STRATEGY THAT ENCOURAGES WASTE REDUCTIONS, EFFICIENT ENERGY AND WATER USE, LOCAL AGRICULTURE PARTNERSHIPS, LESS TOXIC AND FEWER CHEMICAL USE, AND A REDUCTION IN CARBON FROM TRAVEL.PROGRAM SERVICE ACCOMPLISHMENTS:THROUGH PHILANTHROPIC SUPPORT, THE PROVIDENCE MONTANA HEALTH FOUNDATION (PMHF) PROVIDES GRANTS AND ALLOCATIONS TO SUPPORT THE MISSIONS OF PROVIDENCE ST. PATRICK HOSPITAL IN MISSOULA, MT, PROVIDENCE ST. JOSEPH MEDICAL CENTER IN POLSON, MT AND AFFILIATED CLINICS AND PROGRAMS THROUGHOUT WESTERN MONTANA.DURING 2021, THE FOLLOWING ORGANIZATIONS RECEIVED SUPPORT FROM THE FOUNDATION: PROVIDENCE HEALTH & SERVICES MONTANA AND PROVIDENCE ST. JOSEPH MEDICAL CENTER.ST. PATRICK HOUSE IS A PROGRAM OF PMHF AND IS SUPPORTED THROUGH DONATIONS AND GUEST FEES. ST. PATRICK HOUSE HAS 14 BEDROOMS IN A RENOVATED HISTORIC HOME AND WELCOMES PATIENTS AND THEIR FAMILIES WHO HAVE VERIFIED MEDICAL APPOINTMENTS, HOSPITALIZATIONS, OR THERAPY WITH HEALTHCARE PROVIDERS IN MISSOULA WHO ARE IN NEED OF TEMPORARY LODGING.THE PROVIDENCE MONTANA HEALTH FOUNDATION INVESTS CHARITABLE DONATIONS, GRANTS AND RESOURCES IN THE REGION BY SUPPORTING ADVANCED MEDICAL EQUIPMENT, THE ST. PATRICK HOUSE, EXPANSION OF CRITICAL SERVICE LINES TO IMPROVE ACCESS AND QUALITY, FINANCIAL ASSISTANCE FOR PATIENTS AND EMPLOYEES IN NEED, AND PREVENTATIVE PRACTICES AS AN ESSENTIAL COMPONENT OF SUPERIOR MEDICAL CARE. THROUGH PHILANTHROPY, WE STRIVE TO MAKE COMPASSIONATE CARE ACCESSIBLE TO EVERYONE IN OUR REGION. 186 PATIENTS AND 38 EMPLOYEES RECEIVED FINANCIAL ASSISTANCE, 31 INDIVIDUALS RECEIVED SCHOLARSHIPS AND PROFESSIONAL DEVELOPMENT SUPPORT.

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 expenses11,471,219

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	0	1,573,029	259,291

(A) Name and business address	(B) Description of services	(C) Compensation





2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 0

1	Briefly describe the organization’s mission or most significant activities: SEE SCHEDULE O
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	17
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	13
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	13
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

(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/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(18) KITTE ROBINS........................................................................ DIRECTOR	0.50 .......................0.00	X	0	0	0
(19) MARY JO JACKSON........................................................................ DIRECTOR (PART YEAR)	0.50 .......................0.00	X	0	0	0
(20) RON BONE........................................................................ DIRECTOR	0.50 .......................0.00	X	0	0	0

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	808,106
e	Government grants (contributions)		1e	589,379

f	All other contributions, gifts, grants, and similar amounts not included above		1f	4,076,189

g	Noncash contributions included in lines 1a - 1f:$		1g	16,322

h Total. Add lines 1a-1f.......		5,473,674

		Business Code
2a	ST. PATRICK HOUSE	721310	57,652	57,652
b
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		57,652

3 Investment income (including dividends, interest, and othersimilar amounts) ......			588,383			588,383
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents			6a
b	Less: rental expenses			6b
c	Rental income or (loss)			6c
d	Net rental income or (loss).......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		803,452	7a
b	Less: cost or other basis and sales expenses		341,549	7b
c	Gain or (loss)		461,903	7c
d	Net gain or (loss).........			461,903			461,903
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
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..
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..
Business Code			Miscellaneous Revenue
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......
12	Total revenue. See instructions.....			6,581,612	57,652	0	1,050,286

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	11,332,290	11,332,290
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	138,929	138,929
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........	713,820		247,013	466,807
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....
9	Other employee benefits .......	657		227	430
10	Payroll taxes ...........	49,768		17,222	32,546
11	Fees for services (non-employees):
a	Management ......
b	Legal .........
c	Accounting ...........	3,340		1,156	2,184
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17	110,000			110,000
f	Investment management fees ......	78,473		78,473
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	90,282		31,242	59,040
12	Advertising and promotion ....
13	Office expenses .......	25,390		8,786	16,604
14	Information technology ......	1,969		681	1,288
15	Royalties ..
16	Occupancy ...........	46,370		16,046	30,324
17	Travel ............	1,743		603	1,140
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	2,369		820	1,549
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	TAXES AND LICENSES	21,264		7,358	13,906
b	SPECIAL EVENTS	13,573		4,697	8,876
c	DUES & SUBSCRIPTIONS	7,086		2,452	4,634
d	FOUNDATION EXPENSES	3,867		1,338	2,529
e	All other expenses	5,393		1,867	3,526
25	Total functional expenses. Add lines 1 through 24e	12,646,583	11,471,219	419,981	755,383
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			1	1
2	Savings and temporary cash investments .........			819,208	2	-7,741,074
3	Pledges and grants receivable, net ......			2,432,120	3	2,634,056
4	Accounts receivable, net .............				4
5	Loans and other receivables from 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 .......
					5
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) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............				8
9	Prepaid expenses and deferred charges ......				9
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,039,602
b	Less: accumulated depreciation	10b	768,707	307,118	10c	270,895
11	Investments—publicly traded securities .			28,131,741	11	29,687,203
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			2,533,565	15	13,313,497
16	Total assets. Add lines 1 through 15 (must equal line 33)...			34,223,753	16	38,164,577

17	Accounts payable and accrued expenses .....	3,046	17	7,951
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to 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 .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	7,060,389	25	17,970,700
26	Total liabilities. Add lines 17 through 25..	7,063,435	26	17,978,651

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	5,253,817	27	7,069,368
28	Net assets with donor restrictions ...........	21,906,501	28	13,116,558
	Organizations that do not follow FASB ASC 958, check here 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 ...........	27,160,318	32	20,185,926
33	Total liabilities and net assets/fund balances ........	34,223,753	33	38,164,577