Form990


Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
Do not enter social security numbers on this form as it may be made public.
Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2023
Open to Public Inspection
A For the 2023 calendar year, or tax year beginning 09-01-2023 , and ending 08-31-2024
BCheck if applicable:
CName of organization
STANFORD HEALTH CARE TRI-VALLEY
 
% NICOLE PEDIGO
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
1111 E STANLEY BOULEVARD
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
LIVERMORE, CA94550
D Employer identification number

94-1429628
E Telephone number

G Gross receipts $ 541,192,764
F Name and address of principal officer:
KYLE WICHELMANN
1111 E STANLEY BOULEVARD
LIVERMORE,CA94550
I
Tax-exempt status: (   ) (insert no.) or
J
Website:
HTTPS://STANFORDHEALTHCARE.ORG/TRI-VALLEY
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. See instructions.
H(c)
Group exemption number  
K Form of organization:  
L Year of formation: 1957
M State of legal domicile: CA
Part I
Summary
Activities  & Governance 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 11
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 5
5 Total number of individuals employed in calendar year 2023 (Part V, line 2a) ...... 5 1,951
6 Total number of volunteers (estimate if necessary) ............. 6 191
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 300,000
b Net unrelated business taxable income from Form 990-T, Part I, line 11 ......... 7b 130,592
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 2,790,067 1,940,162
9 Program service revenue (Part VIII, line 2g) ......... 467,587,265 530,590,250
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 610,227 737,560
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 1,284,506 -1,514,647
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 472,272,065 531,753,325
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 627,540 261,907
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) 248,560,592 287,698,560
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) 525,000    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 208,537,129 227,963,182
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 457,725,261 515,923,649
19 Revenue less expenses. Subtract line 18 from line 12....... 14,546,804 15,829,676
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 423,138,466 472,654,079
21 Total liabilities (Part X, line 26)............. 146,899,992 154,652,179
22 Net assets or fund balances. Subtract line 21 from line 20..... 276,238,474 318,001,900
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
Signature of officer Date
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name

Firm's EIN
Firm's address



Phone no.
May the IRS discuss this return with the preparer shown above? See Instructions. ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2023)
Form 990 (2023)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: STANFORD HEALTH CARE TRI-VALLEY'S MISSION IS TO (1) ASSUME THE LEADERSHIP ROLE FOR THE HEALTH OF THE TRI-VALLEY COMMUNITY AND (2) TO CARE, TO EDUCATE, AND TO DISCOVER.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 475,280,265 including grants of $ 261,907 ) (Revenue $ 532,774,735 )
SEE SCHEDULE O.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expenses475,280,265
Form 990 (2023)
Form 990 (2023)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment
List of Attached Documents:
// Content
.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? See instructions. Click to see attachment
List of Attached Documents:
// Content
...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment
List of Attached Documents:
// Content
.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment
List of Attached Documents:
// Content
.........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Rev. Proc. 98-19? If "Yes," complete Schedule C, Part IIIClick to see attachment
List of Attached Documents:
// Content
..
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment
List of Attached Documents:
// Content
.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment
List of Attached Documents:
// Content
....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D,
Part IIIClick to see attachment
List of Attached Documents:
// Content
..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment
List of Attached Documents:
// Content
..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part VClick to see attachment
List of Attached Documents:
// Content
......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X, as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D,
Part VI. Click to see attachment
List of Attached Documents:
// Content
...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment
List of Attached Documents:
// Content
.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment
List of Attached Documents:
// Content
.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment
List of Attached Documents:
// Content
............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
List of Attached Documents:
// Content
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
List of Attached Documents:
// Content
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII
Click to see attachment
List of Attached Documents:
// Content
......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
List of Attached Documents:
// Content
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I. See instructions. ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
List of Attached Documents:
// Content
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
List of Attached Documents:
// Content
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
List of Attached Documents:
// Content
21
Yes
 
Form 990 (2023)
Form 990 (2023)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
List of Attached Documents:
// Content
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
List of Attached Documents:
// Content
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I ....
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part II...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part III.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see the Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....
28b
 
No
c
A 35% controlled entity of one or more individuals and/or organizations described in line 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
List of Attached Documents:
// Content
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
List of Attached Documents:
// Content
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
List of Attached Documents:
// Content
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
List of Attached Documents:
// Content
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
List of Attached Documents:
// Content
37
 
No
38
Did the organization complete Schedule O and provide explanations on Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in box 3 of Form 1096. Enter -0- if not applicable ..
1a
100
b
Enter the number of Forms W-2G included on line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2023)
Form 990 (2023)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
1,951
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country:
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources. (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see the instructions and file Form 4720, Schedule N.
15
Yes
 
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
17
Section 501(c)(21) organizations. Did the trust, or any disqualified or other person engage in any activities that would result in the imposition of an excise tax under section 4951, 4952, or 4953? ..
If "Yes," complete Form 6069.
17
 
 
Form 990 (2023)
Form 990 (2023)
Page 6
Part VI
Governance, Management, and Disclosure. For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
11
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
5
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe on Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe on Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process on Schedule O. See instructions.
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filed
CA
18
Section 6104 requires an organization to make its Form 1023 (1024 or 1024-A, if applicable), 990, and 990-T (section 501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
NICOLE PEDIGO1111 E STANLEY BOULEVARD   LIVERMORE,CA94550 (925) 847-3000
Form 990 (2023)
Form 990 (2023)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See the instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (box 5 of Form W-2, box 6 of Form 1099-MISC, and/or box 1 of Form 1099-NEC) of more than $100,000 from the organization and any related organizations.

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

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

See the instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W-2/1099-MISC/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
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) DAVID ENTWISTLE......................................................................
DIRECTOR
4.25
.................
52.4
X           0 5,917,814 96,440
(2) QUINN MCKENNA......................................................................
DIRECTOR
3.0
.................
51.2
X           0 2,913,368 82,184
(3) LINDA HOFF......................................................................
DIRECTOR
3.25
.................
51.4
X           0 2,328,544 197,819
(4) RICHARD SHUMWAY......................................................................
PRESIDENT/CEO
52.5
.................
20.4
    X       1,568,195 0 284,122
(5) AARON SALYAPONGSE MD......................................................................
DIRECTOR
1.6
.................
0.2
X           0 1,113,774 68,317
(6) RON DALMAN MD......................................................................
DIRECTOR
1.6
.................
0.2
X           0 834,476 80,815
(7) DAVID SVEC MD......................................................................
CMO
1.6
.................
0.0
      X     0 602,151 78,871
(8) KYLE WICHELMANN......................................................................
CFO
50.0
.................
12.4
    X       533,543 0 124,605
(9) CHRISTOPHER SHARP MD......................................................................
DIRECTOR
1.6
.................
0.0
X           0 545,782 70,480
(10) TRACEY LEWIS TAYLOR......................................................................
COO (UNTIL 05/24)
50.0
.................
0.0
    X       548,313 0 51,608
(11) MONICA DAVILA......................................................................
INTERIM COO
50.0
.................
0.0
    X       403,686 0 102,404
(12) MANOJ SASTRY......................................................................
INTERIM CAO/VP MKT DEVL
50.0
.................
0.0
      X     400,856 0 96,964
(13) JENNIFER SAAVEDRA......................................................................
REGISTERED NURSE II
50.0
.................
0.0
        X   404,923 0 53,523
(14) PAUL MUSER......................................................................
REGISTERED NURSE II
50.0
.................
0.0
        X   386,165 0 52,021
(15) COLE MENDENHALL......................................................................
REGISTERED NURSE II
50.0
.................
0.0
        X   392,966 0 43,566
(16) CHRISTOPHER LYONS......................................................................
VP HUMAN RESOURCES
50.0
.................
0.0
        X   384,909 0 47,326
(17) HIRUT TRUNEH......................................................................
INTERIM CNO (FROM 03/24)
50.0
.................
0.0
      X     353,438 0 68,537
Form 990 (2023)
Form 990 (2023)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W-2/1099-MISC/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
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) JOHN YEE MD........................................................................
VP CLINICAL INITIATIVES
50.0
.......................2.0
      X     342,096 0 72,439
(19) NICHOLE THOMAS........................................................................
REGISTERED NURSE II
50.0
.......................0.0
        X   391,022 0 11,055
(20) MATTHEW WOLDEN........................................................................
VP OF OPERATIONS
50.0
.......................0.0
      X     277,324 0 29,668
(21) DIANE GRUNSKY........................................................................
FORMER SECRETARY
49.6
.......................0.0
          X 150,238 0 18,132
(22) JACQUELINE STEIN........................................................................
FORMER SECRETARY
0.0
.......................0.0
          X 146,533 0 8,304
(23) SOLEIL CANLAS........................................................................
SECRETARY
50.0
.......................0.4
    X       106,896 0 20,757
(24) JOHN SENSIBA........................................................................
CHAIR
1.6
.......................0.2
X           0 0 0
(25) KAYE FOSTER........................................................................
DIRECTOR
1.6
.......................2.2
X           0 0 0
(26) REENA JADHAV........................................................................
DIRECTOR
1.6
.......................0.0
X           0 0 0
(27) RANDY POND........................................................................
DIRECTOR
1.6
.......................0.2
X           0 0 0
(28) ALCINA WEGRZYNOWSKI........................................................................
DIRECTOR
1.6
.......................0.0
X           0 0 0




1b Sub-Total..............
c Total from continuation sheets to Part VII, Section A..
d Total (add lines 1b and 1c)......... 6,791,103 14,255,909 1,759,957
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization 775
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual
...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
AYA HEALTHCARE INC,
DEPT 3519 PO BOX 123519
DALLAS,TX75312
PATIENT CARE SERVICE 6,801,736
HERRERO BUILDERS INCORPORATE,
2100 OAKDALE AVENUE
SAN FRANCISCO,CA94124
CONSTRUCTION SERVICE 6,210,317
LRS HEALTHCARE,
PO BOX 850349
MINNEAPOLIS,MN55485
PATIENT CARE SERVICE 4,813,511
SODEXO INC AFFILIATES,
9801 WASHINGTON BLVD
GAITHERSBURG,MD20878
HOSPITALITY SERVICE 4,055,490
PREMIER ANESTHESIA OF CALIFORNIA,
2655 NORTHWINDS PARKWAY
ALPHARETTA,GA30009
PATIENT CARE SERVICE 8,956,080
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 50
Form 990 (2023)
Form 990 (2023)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, Grants, and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d  
e Government grants (contributions)1e 1,356,526
f All other contributions, gifts, grants, and similar amounts not included above1f 583,636
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f....... 1,940,162
 Program Service RevenueAmt Business Code
2a PATIENT SERVICES 621990 530,590,250 530,290,250 300,000  
b
c
d
e
f All other program service revenue.        
g Total. Add lines 2a–2f ..... 530,590,250
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ...... 733,221     733,221
4 Income from investment of tax-exempt bond proceeds 0      
5 Royalties........... 0      
(i) Real (ii) Personal
6a Gross rents 6a 5,265,907  
b Less: rental expenses 6b 9,265,039  
c Rental income or (loss) 6c -3,999,132 0
d Net rental income or (loss)....... -3,999,132     -3,999,132
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 7a 0 178,739
b Less: cost or other basis and sales expenses 7b   174,400
c Gain or (loss) 7c 0 4,339
d Net gain or (loss)......... 4,339     4,339
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a 0
b Less: direct expenses ... 8b 0
c Net income or (loss) from fundraising events.. 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a 0
b Less: direct expenses ... 9b 0
c Net income or (loss) from gaming activities.. 0      
10a Gross sales of inventory, less
returns and allowances ..
10a 0
b Less: cost of goods sold .. 10b 0
c Net income or (loss) from sales of inventory.. 0      
 OtherRevenueMiscAmt
Business Code
11a DIETARY SERVICES 900099 774,518 774,518    
b REBATE ON AGREEMENTS 900099 112,105 112,105    
c CLINICAL REVENUE 900099 335,850 335,850    
d All other revenue .... 1,262,012 1,262,012    
e Total. Add lines 11a–11d ...... 2,484,485
12 Total revenue. See instructions..... 531,753,325 532,774,735 300,000 -3,261,572
Form 990 (2023)
Form 990 (2023)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 261,907 261,907
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ........... 0  
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. ............. 0  
4 Benefits paid to or for members ....... 0  
5 Compensation of current officers, directors, trustees, and key employees ........... 4,667,456   4,667,456  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ......... 0      
7 Other salaries and wages........ 199,657,951 189,882,843 9,775,108  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 7,680,276 7,569,609 110,667  
9 Other employee benefits ....... 61,348,656 57,748,935 3,599,721  
10 Payroll taxes ........... 14,344,221 13,212,368 1,131,853  
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 842,110   842,110  
c Accounting ........... 273,686   273,686  
d Lobbying ........... 0      
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 0      
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 32,852,435 30,748,307 2,104,128 0
12 Advertising and promotion .... 0      
13 Office expenses ....... 7,347,023 7,124,354 222,669  
14 Information technology ...... 31,720,262 20,935,373 10,784,889  
15 Royalties .. 0      
16 Occupancy ........... 10,792,953 10,623,964 168,989  
17 Travel ............ 100,452 42,143 58,309  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials . 0      
19 Conferences, conventions, and meetings .... 235,894 219,729 16,165  
20 Interest ........... 1,689,367 1,689,367    
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization .. 19,494,813 19,406,368 88,445  
23 Insurance ... 4,275,532 3,821,270 454,262  
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 MEDICAL SUPPLIES 79,523,856 78,849,768 674,088  
b PURCHASED SERVICES 18,282,475 14,432,839 3,324,636 525,000
c HOSPITAL QUALITY ASSUR FEE 17,254,405 17,254,405    
d LICENSE, TAX & FEES 832,580 387,141 445,439  
e All other expenses 2,445,339 1,069,575 1,375,764  
25 Total functional expenses. Add lines 1 through 24e 515,923,649 475,280,265 40,118,384 525,000
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).        
Form 990 (2023)
Form 990 (2023)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 514 1 0
2 Savings and temporary cash investments ......... 6,013,154 2 4,855,894
3 Pledges and grants receivable, net ...... 0 3 0
4 Accounts receivable, net ............. 54,066,475 4 68,228,216
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 .......
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
0 6 0
7 Notes and loans receivable, net ........... 0 7 0
8 Inventories for sale or use ............ 10,501,829 8 12,280,587
9 Prepaid expenses and deferred charges ...... 9,911,676 9 2,761,855
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 473,559,218
b Less: accumulated depreciation 10b 153,025,800 297,333,930 10c 320,533,418
11 Investments—publicly traded securities . 0 11 0
12 Investments—other securities. See Part IV, line 11 ..... 0 12 0
13 Investments—program-related. See Part IV, line 11 .. 0 13 0
14 Intangible assets ............... 212,328 14 0
15 Other assets. See Part IV, line 11 ........... 45,098,560 15 63,994,109
16 Total assets. Add lines 1 through 15 (must equal line 33)... 423,138,466 16 472,654,079
Liabilities 17 Accounts payable and accrued expenses ..... 43,731,232 17 43,121,610
18 Grants payable ... 0 18 0
19 Deferred revenue ......... 10,600,462 19 3,628,023
20 Tax-exempt bond liabilities ......... 0 20 0
21 Escrow or custodial account liability. Complete Part IV of Schedule D 0 21 0
22 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 0 23 0
24 Unsecured notes and loans payable to unrelated third parties .. 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D 92,568,298 25 107,902,546
26 Total liabilities. Add lines 17 through 25.. 146,899,992 26 154,652,179
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 271,081,671 27 313,309,878
28 Net assets with donor restrictions ........... 5,156,803 28 4,692,022
Organizations that do not follow FASB ASC 958, check here right arrow 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 ........... 276,238,474 32 318,001,900
33 Total liabilities and net assets/fund balances ........ 423,138,466 33 472,654,079
Form 990 (2023)
Form 990 (2023)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
531,753,325
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
515,923,649
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
15,829,676
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
276,238,474
5
Net unrealized gains (losses) on investments ...............
5
 
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
25,933,750
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
318,001,900
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain on
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Uniform Guidance, 2 C.F.R. Part 200, Subpart F?
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2023)
Form 990 (2023)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
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
2023
Open to Public
Inspection
Name of the organization
STANFORD HEALTH CARE TRI-VALLEY
 
Employer identification number

94-1429628
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)
1
A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).
2
A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)
3
A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).
4
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:

5
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.)
6
A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).
7
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.)
8
A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)
9
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:
10
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.)
11
12
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.
a
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.
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.
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.
d
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.
e
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.
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total
 
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990) 2023

Schedule A (Form 990) 2023
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2019 (b) 2020 (c) 2021 (d) 2022 (e) 2023 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf ....            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) ..  
6 Public support. Subtract line 5 from line 4.  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2019 (b) 2020 (c) 2021 (d) 2022 (e) 2023 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..            
11 Total support. Add lines 7 through 10  
12
12
 
13
First 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
14
14
 
15
15
 
16a
33 1/3% support test—2023. 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
b
33 1/3% support test—2022. 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—2023. 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
b
10%-facts-and-circumstances test—2022. 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
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990) 2023

Schedule A (Form 990) 2023
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2019 (b) 2020 (c) 2021 (d) 2022 (e) 2023 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose            
3 Gross receipts from activities that are not an unrelated trade or business under section 513 .....            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge            
6 Total. Add lines 1 through 5            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support. (Subtract line 7c from line 6.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2019 (b) 2020 (c) 2021 (d) 2022 (e) 2023 (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.)..            
14
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
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
33 1/3% support tests-2023. 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
b
33 1/3 % support tests—2022. 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
20
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) 2023

Schedule A (Form 990) 2023
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
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer 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).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .
7
 
 
8
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).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
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.
9b
 
 
c
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.
9c
 
 
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
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
Schedule A (Form 990) 2023

Schedule A (Form 990) 2023
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described on 11a above?
11b
 
 
c
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
No
1
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.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in 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.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer lines 2a and 2b below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described 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.
2b
 
 
3
Parent of Supported Organizations. Answer lines 3a and 3b below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990) 2023

Schedule A (Form 990) 2023
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
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  
7
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) 2023

Schedule A (Form 990) 2023
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 2023 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-2023
(iii)
Distributable
Amount for 2023
1 Distributable amount for 2023 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI).
See instructions.
 
3 Excess distributions carryover, if any, to 2023:
a From 2018.......  
b From 2019.......  
c From 2020.......  
d From 2021.......  
e From 2022.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2023 distributable amount  
i Carryover from 2018 not applied (see
instructions)
 
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.  
4Distributions for 2023 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2023 distributable amount  
c Remainder. Subtract lines 4a and 4b from line 4.  
5 Remaining underdistributions for years prior to
2023, 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 2023. 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 2024. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a Excess from 2019.....  
b Excess from 2020.....  
c Excess from 2021.....  
d Excess from 2022.....  
e Excess from 2023.....  
Schedule A (Form 990) (2023)

Schedule A (Form 990) 2023
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 


Return Reference Explanation
Schedule A (Form 990) 2023


Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2023
Name of the organization
STANFORD HEALTH CARE TRI-VALLEY
 
Employer identification number

94-1429628
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ






Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990) (2023)
Schedule B (Form 990) (2023) Page 2
Name of organization
STANFORD HEALTH CARE TRI-VALLEY
 
Employer identification number
94-1429628
Part I
Contributors
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
RESTRICTED
 
 
 
 
  ,    

$ RESTRICTED


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

$  


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

$  


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

$  


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

$  


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

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990) (2023)
Schedule B (Form 990) (2023)
Page 3
Name of organization
STANFORD HEALTH CARE TRI-VALLEY
 
Employer identification number

94-1429628
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) (2023)
Schedule B (Form 990) (2023)
Page 4
Name of organization
STANFORD HEALTH CARE TRI-VALLEY
 
Employer identification number

94-1429628
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990) (2023)
Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

right arrow Complete if the organization is described below. right arrow Attach to Form 990 or Form 990-EZ.
right arrowGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2022
Open to Public
Inspection
If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
STANFORD HEALTH CARE TRI-VALLEY
 
Employer identification number

94-1429628
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

2
Political campaign activity expenditures. See instructions ....................................................................right arrow
$  
3
Volunteer hours for political campaign activities. See instructions ..................................................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 ................................right arrow
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 .......................right arrow
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................
4a
Was a correction made? ......................................................................................................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... right arrow
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................right arrow

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b...........right arrow

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6
For Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990) 2022

Schedule C (Form 990) 2022
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check right arrowexpenses, and share of excess lobbying expenditures).
B Check right arrow
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.)
(a) Filing
organization's
totals
(b) Affiliated group totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................    
b Total lobbying expenditures to influence a legislative body (direct lobbying) ........................    
c Total lobbying expenditures (add lines 1a and 1b) ............................................................    
d Other exempt purpose expenditures ...............................................................................    
e Total exempt purpose expenditures (add lines 1c and 1d) ..................................................    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.
   
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................................................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ...................................................................................................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in)
(a) 2019 (b) 2020 (c) 2021 (d) 2022 (e) Total
2a Lobbying nontaxable amount          
b Lobbying ceiling amount
(150% of line 2a, column(e))
 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))
 
f Grassroots lobbying expenditures          
Schedule C (Form 990) 2022


Schedule C (Form 990) 2022
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
Yes|No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
 
No
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
 
No
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
24,015
j
Total. Add lines 1c through 1i ....................................................................................................
24,015
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures. See Instructions .........................................
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
PART II-B, LINE 1 LOBBYING ACTIVITIES: SHC TRI-VALLEY BELONGS TO THE CALIFORNIA HOSPITAL ASSOCIATION/HOSPITAL COUNCIL OF NORTHERN & CENTRAL CALIFORNIA IN WHICH A PORTION OF DUES PAID TO THESE ORGANIZATIONS IS SPENT ON EFFORTS TO INFLUENCE LEGISLATION MATTERS IN THE HEALTH CARE INDUSTRY. DURING FY24, SHC TRI-VALLEY PAID DUES OF $132,902 TO THESE ORGANIZATIONS AND THE APPROXIMATE AMOUNT OF DUES SPENT ON LOBBYING PURPOSES WAS $24,015.
Schedule C (Form 990) 2022


Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
right arrow 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.
right arrow Attach to Form 990.
right arrow Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2022
Open to Public Inspection
Name of the organization
STANFORD HEALTH CARE TRI-VALLEY
 
Employer identification number

94-1429628
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after July 25, 2006, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year right arrow  
4
Number of states where property subject to conservation easement is located right arrow  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included on Form 990, Part VIII, line 1 .........................right arrow $  
(ii)
Assets included in Form 990, Part X ...............................right arrow $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................right arrow $  
b
Assets included in Form 990, Part X ...............................right arrow $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2022

Schedule D (Form 990) 2022
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c  
d Additions during the year ............................ 1d  
e Distributions during the year .......................... 1e  
f Ending balance ................................ 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....
Part V
Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.
(a) Current year (b) Prior year (c) Two years back (d) Three years back (e) Four years back
1a Beginning of year balance ....          
b Contributions ...          
c Net investment earnings, gains, and losses          
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ...
         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment right arrow  
b
Permanent endowment right arrow  
c
Term endowment right arrow  
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .................
3a(i)
 
 
(ii) Related organizations .................
3a(ii)
 
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis
(investment)
(b) Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .....   51,124,005 51,124,005
b Buildings ....   231,769,314 44,470,240 187,299,074
c Leasehold improvements   21,926,248 10,036,307 11,889,941
d Equipment ....   158,809,363 93,678,383 65,130,980
e Other .....   9,930,288 4,840,870 5,089,418
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..right arrow 320,533,418
Schedule D (Form 990) 2022

Schedule D (Form 990) 2022
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.)right arrow  
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.)right arrow  
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)NON PATIENT RECEIVABLES 319,116
(2)DEPOSITS 631,864
(3)EQUITY INVESTMENT PPA-I 1,678,694
(4)EQUITY INVESTMENT PPA-II 7,627,844
(5)HOSP QUAL ASSURANCE RECEIVABLE 5,308,419
(6)INTERCOMPANY RECEIVABLE 783,983
(7)RIGHT OF USE ASSETS 46,256,530
(8)GOVERNMENT RECEIVABLES 1,387,659
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........right arrow 63,994,109
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 0
INTERCOMPANY NOTE 47,927,073
ASSET RETIREMENT OBLIGATION 4,427,106
HOSPITAL QUALITY ASSURANCE PAY 3,528,634
SELF INSURANCE RESERVES 5,155,000
INTERCOMPANY PAYABLE 324,223
REFUNDABLE DEPOSITS 233,936
RIGHT-OF-USE ASSET LEASE LIABILITY 46,306,574


Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)right arrow 107,902,546
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) 2022

Schedule D (Form 990) 2022
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 X, LINE 2 FIN 48 SHC AND ITS SUBSIDIARIES HAVE NO UNCERTAIN TAX POSITIONS PERTAINING TO UNRELATED BUSINESS INCOME.
Schedule D (Form 990) 2022


Additional Data


Software ID:  
Software Version:  




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
Medium right arrow Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
Medium right arrow Attach to Form 990.
Medium right arrow Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2023
Open to Public Inspection
Name of the organization
STANFORD HEALTH CARE TRI-VALLEY
 
Employer identification number

94-1429628
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . .
    2,052,326   2,052,326 0.400 %
b Medicaid (from Worksheet 3, column a) . . . . .     29,113,301 26,116,204 2,997,096 0.580 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     59,432,796 21,502,513 37,930,282 7.350 %
d Total Financial Assistance and Means-Tested Government Programs . . . . .     90,598,423 47,618,717 42,979,704 8.330 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4). 22 6,927 1,628,672 804,438 824,234 0.160 %
f Health professions education (from Worksheet 5) . . . 11 231 2,053,020 0 2,053,020 0.400 %
g Subsidized health services (from Worksheet 6) . . . .            
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . . 7 12,781 1,082,956 602,504 480,452 0.090 %
j Total. Other Benefits . . 40 19,939 4,764,648 1,406,942 3,357,706 0.650 %
k Total. Add lines 7d and 7j . 40 19,939 95,363,071 49,025,659 46,337,410 8.980 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2023
Schedule H (Form 990) 2023
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue
(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing 1 0 6,550 0 6,550  
2 Economic development 1 0 25,000 0 25,000  
3 Community support            
4 Environmental improvements            
5 Leadership development and
training for community members
           
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development 4 888 258,080 0 258,080  
9 Other            
10 Total 6 888 289,630 0 289,630  
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
18,380,087
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
155,985,973
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
249,602,982
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-93,617,009
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity
(c) Organization's
profit % or stock
ownership %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership %
(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2023
Schedule H (Form 990) 2023
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
Licensed Hospital General Medical and Surgical Children's Hospital Teaching Hospital Critical Access Hospital Research Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 STANFORD HEALTH CARE TRI-VALLEY
1111 E STANLEY BLVD
LIVERMORE,CA94550
STANFORDHEALTHCARE.ORG/TRI-VALLEY
140000114
X X         X   MED FITNESS FACILITY URGENT CARE WOMEN'S CENTER  
Schedule H (Form 990) 2023
Schedule H (Form 990) 2023
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
STANFORD HEALTH CARE TRI-VALLEY
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
 
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 21
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 22
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE PART V
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2023
Schedule H (Form 990) 2023
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
STANFORD HEALTH CARE TRI-VALLEY
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE PART V
b
SEE PART V
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2023
Schedule H (Form 990) 2023
Page 6
Part VFacility Information (continued)

Billing and Collections
STANFORD HEALTH CARE TRI-VALLEY
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2023
Schedule H (Form 990) 2023
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
STANFORD HEALTH CARE TRI-VALLEY
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2023
Schedule H (Form 990) 2023
Page 8
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
PART V, SECTION B TWO FACILITIES OPERATE UNDER SHC TRI-VALLEY'S LICENSE WITH THE FOLLOWING ADDRESSES. 1111 E STANLEY BLVD LIVERMORE, CA 94550 5555 W LAS POSITAS BLVD PLEASANTON, CA 94588
PART V, SECTION B, LINE 5 THE HOSPITAL COMMISSIONED AN INDEPENDENT LOCAL RESEARCH FIRM, ACTIONABLE INSIGHTS, LLC ("AI"), TO ASSIST WITH THE VARIOUS ASSESSMENTS FOR THE 2021-2023 CHNA CYCLE. STANFORD HEALTH CARE TRI-VALLEY (SHC TRI-VALLEY) AND 12 OTHER HOSPITALS IN ALAMEDA AND CONTRA COSTA COUNTIES (SUBSEQUENTLY REFERRED TO AS "THE HOSPITALS") COLLABORATED FOR THE PURPOSE OF IDENTIFYING CRITICAL HEALTH NEEDS OF THE COMMUNITY. WORKING TOGETHER, THE HOSPITALS CONDUCTED AN EXTENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE 2022 CHNA BUILT UPON EARLIER ASSESSMENTS CONDUCTED BY THE HOSPITALS. AI COMPLETED THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT. TO DO SO, AI ASSISTED SHC TRI-VALLEY WITH CHNA PLANNING, COLLECTED SECONDARY DATA, SYNTHESIZED SECONDARY DATA AND KEY PRIMARY DATA INSIGHTS, FACILITATED THE PROCESSES OF IDENTIFYING COMMUNITY ASSETS AND HEALTH NEEDS, ASSISTED WITH DETERMINING THE PRIORITIZATION OF COMMUNITY HEALTH NEEDS, AND DOCUMENTED THE PROCESSES AND FINDINGS IN THIS REPORT. ADDITIONALLY, FOR THE 2021-2023 CHNA CYCLE, SHC TRI-VALLEY EMPLOYED AD LUCEM TO CONDUCT AND ANALYZE KEY INFORMANT INTERVIEWS AND ANALYZED FOCUS GROUP DATA, PROVIDING KEY THEMES AND QUOTES, AND TO DESCRIBE THE PROCESSES AND METHODS IT USED IN THOSE EFFORTS. UTILIZING THE SERVICES OF BOTH AI AND AD LUCEM, PRIMARY AND SECONDARY RESEARCH, WAS COLLECTED AND SYNTHESIZED FOR A FINAL HEALTH NEEDS LIST, ASSISTED WITH THE HOSPITALS' PRIORITIZATION OF COMMUNITY HEALTH NEEDS AND DOCUMENTED THE PROCESS AND FINDINGS IN A REPORT. DURING THE 2022 CHNA PROCESS, THE HOSPITAL TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED, INCLUDING FROM THOSE WITH SPECIAL KNOWLEDGE AND EXPERTISE IN PUBLIC HEALTH THROUGH INTERVIEWS OF PUBLIC AND COMMUNITY HEALTH LEADERS, ADVOCATES AND EXPERTS. INPUT WAS ALSO GATHERED FROM RESIDENT AND PROFESSIONAL FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WHICH REPRESENTED THE FOLLOWING POPULATIONS MEDICALLY UNDERSERVED, LOW-INCOME INDIVIDUALS AND MINORITY POPULATIONS. FINDINGS REGARDING COMMUNITY HEALTH CONCERNS THAT HAD BEEN IDENTIFIED FROM AN ANALYSIS OF SECONDARY DATA WERE DISCUSSED WITH GROUPS OF PEOPLE FROM UNDERSERVED, MINORITY AND LOW-INCOME POPULATIONS. CONSULTING FIRMS APPLIED SURVEY RESEARCH (ASR) AND AD LUCEM CONSULTING CONDUCTED A TOTAL OF 10 KEY INFORMANT INTERVIEWS RELEVANT TO THE TRI-VALLEY AREA. INTERVIEWEES INCLUDED ORGANIZATIONS SERVING BOTH ALAMEDA AND CONTRA COSTA COUNTIES AS WELL AS ORGANIZATIONS FOCUSED ON THE TRI-VALLEY. INTERVIEWEES REPRESENTED DIVERSE SECTORS INCLUDING: PUBLIC HEALTH, HEALTH CARE, MENTAL HEALTH CARE, FOOD ASSISTANCE, HOMELESS AND SOCIAL SERVICES, AND EDUCATION. THE KEY INFORMANTS WERE IDENTIFIED BY MEMBERS OF THE ALAMEDA CONTRA COSTA HOSPITAL COUNCIL CHNA COLLABORATIVE AND STANFORD HEALTH CARE TRI-VALLEY STAFF. ALL INTERVIEWS WERE CONDUCTED BY TELEPHONE IN ENGLISH AND FOLLOWED A STANDARD SET OF INTERVIEW QUESTIONS AND THE INTERVIEWERS TOOK DETAILED NOTES DURING THE CALL. AT THE BEGINNING OF THE INTERVIEW, CONFIDENTIALITY WAS ASSURED. FIVE COMMUNITY RESIDENT FOCUS GROUPS WERE CONDUCTED: TWO IN ALAMEDA COUNTY AND THREE IN CENTRAL CONTRA COSTA COUNTY. THREE GROUPS WERE CONDUCTED IN ENGLISH, TWO WERE CONDUCTED IN SPANISH. PARTICIPANTS WERE FROM UNDERSERVED, LOW-INCOME COMMUNITIES. THE LIST BELOW CONTAINS THE DETAILS OF LEADERS, REPRESENTATIVES, AND MEMBERS WHO WERE CONSULTED FOR THEIR EXPERTISE IN THE COMMUNITY. LEADERS WERE IDENTIFIED BASED ON THEIR PROFESSIONAL EXPERTISE AND KNOWLEDGE OF TARGET GROUPS INCLUDING LOW-INCOME POPULATIONS, MINORITIES, AND THE MEDICALLY UNDERSERVED. ID#: 1 DATA COLLECTION METHOD: INTERVIEW TITLE, AGENCY: LEADERSHIP, OPEN HEART KITCHEN TOPIC: HOMELESSNESS, FOOD INSECURITY #OF PEOPLE: 1 TARGET GROUP(S) REPRESENTED: LOW-INCOME, OLDER ADULTS, YOUTH ROLE IN TARGET GROUP: LEADER DATE INPUT WAS GATHERED: 7/22/2021 ID#: 2 DATA COLLECTION METHOD: INTERVIEW TITLE, AGENCY: LEADER, ALAMEDA COUNTY COMMUNITY FOOD BANK TOPIC: FOOD INSECURITY #OF PEOPLE: 1 TARGET GROUP(S) REPRESENTED: LOW-INCOME ROLE IN TARGET GROUP: LEADER DATE INPUT WAS GATHERED: 7/27/2021 ID#: 3 DATA COLLECTION METHOD: INTERVIEW TITLE, AGENCY: LEADERSHIP & DIRECTOR LEVEL, TRI-VALLEY HAVEN TOPIC: FOOD INSECURITY #OF PEOPLE: 2 TARGET GROUP(S) REPRESENTED: LOW-INCOME ROLE IN TARGET GROUP: LEADER DATE INPUT WAS GATHERED: 8/4/2021 ID#: 4 DATA COLLECTION METHOD: INTERVIEW TITLE, AGENCY: PROGRAM MANAGER, ALAMEDA COUNTY PUBLIC HEALTH DEPARTMENT TOPIC: PUBLIC HEALTH #OF PEOPLE: 1 TARGET GROUP(S) REPRESENTED: LOW-INCOME, MEDICALLY UNDERSERVED, MINORITY ROLE IN TARGET GROUP: LEADER DATE INPUT WAS GATHERED: 8/9/2021 ID#: 5 DATA COLLECTION METHOD: INTERVIEW TITLE, AGENCY: LEADERSHIP & NURSE, LIVERMORE VALLEY JOINT UNIFIED SCHOOL DISTRICT TOPIC: EDUCATION #OF PEOPLE: 2 TARGET GROUP(S) REPRESENTED: MEDICALLY UNDERSERVED, YOUTH ROLE IN TARGET GROUP: LEADER DATE INPUT WAS GATHERED: 8/27/2021 ID#: 6 DATA COLLECTION METHOD: INTERVIEW TITLE, AGENCY: CO-FOUNDER, Z-CARES FOUNDATION TOPIC: YOUTH MENTAL HEALTH #OF PEOPLE: 1 TARGET GROUP(S) REPRESENTED: YOUTH ROLE IN TARGET GROUP: LEADER DATE INPUT WAS GATHERED: 9/21/2021 ID#: 7 DATA COLLECTION METHOD: INTERVIEW TITLE, AGENCY: CEO & CHIEF DEVELOPMENT OFFICER, AXIS COMMUNITY HEALTH TOPIC: ACCESS TO CARE #OF PEOPLE: 2 TARGET GROUP(S) REPRESENTED: MEDICALLY UNDERSERVED ROLE IN TARGET GROUP: LEADER DATE INPUT WAS GATHERED: 9/21/2021 ID#: 8 DATA COLLECTION METHOD: INTERVIEW TITLE, AGENCY: DIRECTOR OF STUDENT SERVICES, DUBLIN UNIFIED SCHOOL DISTRICT TOPIC: EDUCATION #OF PEOPLE: 1 TARGET GROUP(S) REPRESENTED: YOUTH ROLE IN TARGET GROUP: LEADER DATE INPUT WAS GATHERED: 10/19/2021 ID#: 9 DATA COLLECTION METHOD: INTERVIEW TITLE, AGENCY: ASSISTANT SUPERINTENDENT, PLEASANTON UNIFIED SCHOOL DISTRICT TOPIC: EDUCATION #OF PEOPLE: 1 TARGET GROUP(S) REPRESENTED: YOUTH ROLE IN TARGET GROUP: LEADER DATE INPUT WAS GATHERED: 10/20/2021 ID#: 10 DATA COLLECTION METHOD: INTERVIEW TITLE, AGENCY: EPIDEMIOLOGIST/BIOSTATISTICIAN & PUBLIC HEALTH ACCREDITATION COORDINATOR, CONTRA COSTA HEALTH SERVICES TOPIC: PUBLIC HEALTH #OF PEOPLE: 2 TARGET GROUP(S) REPRESENTED: LOW-INCOME, MEDICALLY UNDERSERVED ROLE IN TARGET GROUP: LEADER DATE INPUT WAS GATHERED: 11/5/2021 COMMUNITY RESIDENTS (FOCUS GROUPS) ID#: 11 DATA COLLECTION METHOD: FOCUS GROUP TITLE, AGENCY: HOST: CONTRA COSTA HEALTH SERVICES TOPIC: SPANISH-SPEAKING LATINX RESIDENTS #OF PEOPLE: 10 TARGET GROUP(S) REPRESENTED: MINORITY ROLE IN TARGET GROUP: MEMBER DATE INPUT WAS GATHERED: 9/23/2021 ID#: 12 DATA COLLECTION METHOD: FOCUS GROUP TITLE, AGENCY: HOST: LA FAMILIA TOPIC: SPANISH- SPEAKING LATINX OLDER ADULTS #OF PEOPLE: 9 TARGET GROUP(S) REPRESENTED: LOW-INCOME, MINORITY, OLDER ADULTS ROLE IN TARGET GROUP: MEMBER DATE INPUT WAS GATHERED: 9/24/2021 ID#: 13 DATA COLLECTION METHOD: FOCUS GROUP TITLE, AGENCY: HOST: CONTRA COSTA HEALTH SERVICES TOPIC: OLDER ADULTS #OF PEOPLE: 9 TARGET GROUP(S) REPRESENTED: MINORITY ROLE IN TARGET GROUP: MEMBER DATE INPUT WAS GATHERED: 9/28/2021 ID#: 14 DATA COLLECTION METHOD: FOCUS GROUP TITLE, AGENCY: HOST: CONTRA COSTA HEALTH SERVICES TOPIC: BLACK RESIDENTS #OF PEOPLE: 2 TARGET GROUP(S) REPRESENTED: MINORITY ROLE IN TARGET GROUP: MEMBER DATE INPUT WAS GATHERED: 9/29/2021 ID#: 15 DATA COLLECTION METHOD: FOCUS GROUP TITLE, AGENCY: HOST: GOODNESS VILLAGE TOPIC: FORMERLY HOMELESSNESS RESIDENTS #OF PEOPLE: 9 TARGET GROUP(S) REPRESENTED: LOW-INCOME ROLE IN TARGET GROUP: MEMBER DATE INPUT WAS GATHERED: 10/6/2021
PART V, SECTION B, LINE 6A STANFORD HEALTH CARE TRI-VALLEY COLLABORATED WITH THE FOLLOWING HEALTH SYSTEMS AND ORGANIZATIONS TO PREPARE THE 2022 CHNA: - ALAMEDA COUNTY PUBLIC HEALTH DEPARTMENT - APPLIED SURVEY RESEARCH - CONTRA COSTA HEALTH SERVICES - JOHN MUIR HEALTH - KAISER PERMANENTE - DIABLO AREA (ANTIOCH AND WALNUT CREEK KAISER FOUNDATION HOSPITALS) - KAISER PERMANENTE - EAST BAY AREA (OAKLAND AND RICHMOND KAISER FOUNDATION HOSPITALS) - KAISER PERMANENTE - GREATER SOUTHERN ALAMEDA AREA (FREMONT AND SAN LEANDRO KAISER FOUNDATION HOSPITALS) - ST. ROSE HOSPITAL - SUTTER HEALTH BAY AREA (ALTA BATES SUMMIT MEDICAL CENTER AND HERRICK CAMPUS, DELTA MEDICAL CENTER, AND EDEN MEDICAL CENTER) - UCSF BENIOFF CHILDREN'S HOSPITAL
PART V, SECTION B, LINES 7A/10A URL AT WHICH THE CHNA AND IMPLEMENTATION STRATEGY ARE AVAILABLE: HTTPS://STANFORDHEALTHCARE.ORG/TRI-VALLEY/ABOUT-US/COMMUNITY-BENEFITS.HTML PLEASE NOTE THAT LINK MUST BE ENTERED IN LOWER CASE LETTERS IN URL.
PART V, SECTION B, LINE 11 SHC TRI-VALLEY'S COMMUNITY BENEFIT ADVISORY GROUP (CBAG) MET ON MARCH 2, 2022 TO REVIEW THE HEALTH NEEDS IDENTIFIED DURING THE ASSESSMENT AND TO PARTICIPATE IN THE PRIORITIZATION PROCESS. (THE CBAG MEMBERS WHO PARTICIPATED ARE LISTED IN THE PROCESS AND METHODS SECTION OF THIS REPORT.) THE CBAG USED THESE CRITERIA TO PRIORITIZE THE LIST OF HEALTH NEEDS: - COMMUNITY PRIORITY. THE COMMUNITY PRIORITIZES THE ISSUE OVER OTHER ABOUT WHICH IT HAS EXPRESSED CONCERN DURING THE CHNA PRIMARY DATA COLLECTION PROCESS. - CLEAR DISPARITIES OR INEQUITIES. THIS REFERS TO DIFFERENCES IN HEALTH OUTCOMES BY SUBGROUPS. SUBGROUPS MAY BE BASED ON GEOGRAPHY, LANGUAGE, ETHNICITY, CULTURE, CITIZENSHIP STATUS, ECONOMIC STATUS, SEXUAL ORIENTATION, AGE, GENDER, OR OTHERS. - LACKING SUFFICIENT COMMUNITY ASSETS AND/OR RESOURCES. THE IRS REQUIRES THAT HOSPITALS TAKE INTO CONSIDERATION WHETHER EXISTING ASSETS/ RESOURCES ARE AVAILABLE TO ADDRESS THE ISSUE. - MULTIPLIER EFFECT. A SUCCESSFUL SOLUTION TO THE HEALTH NEED HAS TO SOLVE MULTIPLE PROBLEMS. FOR EXAMPLE, IF RATES OF OBESITY GO DOWN, DIABETES RATES COULD ALSO GO DOWN. PRIORITIZED 2022 HEALTH NEEDS BASED ON THOSE CRITERIA, THE CBAG MEMBERS REACHED CONSENSUS IN RANKING NINE COMMUNITY HEALTH NEEDS. THESE NEEDS ARE LISTED BELOW IN OUR HOSPITAL'S PRIORITY ORDER, FROM HIGHEST TO LOWEST. SUMMARIZED DESCRIPTIONS OF EACH NEED, INCLUDING STATISTICAL DATA AND COMMUNITY FEEDBACK, APPEAR IN THE COMMUNITY HEALTH NEEDS OF THIS REPORT. 1. HOUSING AND HOMELESSNESS 2. BEHAVIORAL HEALTH 3. ECONOMIC STABILITY 4. HEALTHY EATING/ACTIVE LIVING, DIABETES AND OBESITY 5. HEALTH CARE ACCESS AND DELIVERY 6. COMMUNITY SAFETY 7. HEART DISEASE AND STROKE 8. CANCER 9. CLIMATE AND NATURAL ENVIRONMENT
PART V, SECTION B, LINE 16A-C URL AT WHICH THE FAP, FAP APPLICATION, AND PLAIN LANGUAGE SUMMARY IS AVAILABLE: HTTPS://STANFORDHEALTHCARE.ORG/TRI-VALLEY/PATIENTS-AND-VISITORS/FINANCIAL- ASSISTANCE.HTML PLEASE NOTE THAT LINK MUST BE ENTERED IN LOWER CASE LETTERS IN URL.
PART V, SECTION B, LINE 20A SHC TRI-VALLEY WILL PURSUE PAYMENT FOR DEBTS OWED FOR HEALTH CARE SERVICES PROVIDED BY SHC TRI-VALLEY. ALL PATIENT ACCOUNT BALANCES THAT MEET SHC TRI-VALLEY CRITERIA FOR ASSIGNMENT TO BAD DEBT ACCORDING TO THE DEBT COLLECTION POLICY ARE ELIGIBLE FOR PLACEMENT WITH A COLLECTION AGENCY. HOWEVER, SHC TRI-VALLEY DOES NOT CURRENTLY ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIVITY (ECA). PER SHC TRI-VALLEY POLICY, ECA IS DEFINED TO INCLUDE PLACING LIENS ON INDIVIDUAL PROPERTY, FORECLOSING CAUSING ON REAL PROPERTY, COMMENCING A CIVIL ACTION AGAINST AN ARREST, GARNISHING WAGES, REPORTING ADVERSE INFORMATION TO A CREDIT AGENCY, DEFERRING OR DENYING MEDICALLY NECESSARY CARE, REQUIRING PAYMENT BEFORE PROVIDING MEDICALLY NECESSARY CARE BECAUSE OF OUTSTANDING BILLS, AND SALE OF DEBT TO A THIRD PARTY.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2023
Schedule H (Form 990) 2023
Page 9
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?  
Name and address Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2023
Schedule H (Form 990) 2023
Page 10
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
PART I, LINE 6A: UNDER STATE LAW SB 697, THE STATE OF CALIFORNIA REQUIRES ALL NON-PROFIT HOSPITALS IN CALIFORNIA TO COMPLETE AND SUBMIT AN ANNUAL COMMUNITY BENEFIT REPORT. ALTHOUGH HOSPITALS BRING NUMEROUS BENEFITS TO THEIR LOCAL ECONOMIES, THESE REPORTS ARE INTENDED TO DOCUMENT THE WAYS IN WHICH EACH HOSPITAL GOES ABOVE AND BEYOND THE CORE FUNCTIONS OF A HOSPITAL TO SUPPORT THE HEALTH NEEDS OF ITS COMMUNITY.
PART I, LINE 7: RATIO OF PATIENT CARE COST TO CHARGES WAS USED TO CALCULATE THE AMOUNTS INCLUDED IN THE TABLE AT SCHEDULE H, PART I, LINES 7A AND 7B. AMOUNTS INCLUDED IN OTHER LINES WERE BASED ON SHC TRI-VALLEY'S COST ACCOUNTING INFORMATION, INCLUDING AVERAGE HOURLY WAGES FOR STAFF TIME DEVOTED TO SPECIFIC PROGRAMS, AVERAGE COST OF SPACE USED BY COMMUNITY HEALTH PROGRAMS, INDIRECT COST FACTORS, AND RELATED INFORMATION.
PART II, LINE 8: THE FOLLOWING PROGRAMS ADDRESS COMMUNITY WIDE WORKFORCE ISSUES. THESE PROGRAMS STRENGTHEN THE COMMUNITIES' CAPACITY TO PROMOTE THE HEALTH AND WELL-BEING OF ITS RESIDENCES BY OFFERING THE EXPERTISE AND RESOURCES OF SHC TRI-VALLEY. SPECIALIZED HEALTH CARE WORKFORCE TRAINING SHC TRI-VALLEY PROVIDED CLINICAL EXPERIENCE AND PRECEPTORS FOR GRADUATE NURSING STUDENTS. STUDENTS RECEIVED EXPOSURE TO AND EXPERIENCE IN THE POSITIONS OF NURSE PRACTITIONER, NURSING ADMINISTRATION, AND CLINICAL NURSE SPECIALIST. SHC TRI-VALLEY REGISTERED NURSES IN MULTIPLE NURSING UNITS, INCLUDING MEDICAL/SURGICAL AND INTENSIVE CARE UNITS, PROVIDED DIRECT SUPERVISION IN A CLINICAL ENVIRONMENT TO STUDENT NURSES CONNECTED WITH PROGRAMS INCLUDING CHABOT COLLEGE, OHLONE COLLEGE, CSU EAST BAY, SMU, AND SJSU. APPROXIMATELY 202 STUDENTS PARTICIPATED DURING THE REPORTING PERIOD. SHC TRI-VALLEY PROVIDED SURGICAL TECHNOLOGY (ST) TRAINING FOR STUDENTS IN THE OPERATING ROOM, SUPERVISED BY A SURGICAL TECHNOLOGIST AND REGISTERED NURSES. 1 STUDENT PARTICIPATED DURING THE REPORTING PERIOD. SHC TRI-VALLEY PROVIDED EDUCATION FOR 2 STUDENTS FROM LAS POSITAS COLLEGE AND CALIFORNIA STATE UNIVERSITY SACRAMENTO WHO WERE TRAINING TO BECOME PARAMEDICS. THROUGHOUT THE YEAR, SHC TRI-VALLEY HOSTED 7 COLLEGE STUDENT INTERNS IN PHYSICAL AND OCCUPATIONAL THERAPY IN VARYING AFFILIATION PERIODS. STUDENTS RECEIVED ON-THE-JOB INSTRUCTION AND HANDS-ON TREATMENT SKILLS IN THE INPATIENT AND/OR OUTPATIENT SETTING IN ORDER TO MEET THE REQUIREMENTS FOR THEIR DEGREES AND LICENSURE. DURING FY24, SHC TRI-VALLEY HOSTED TEN (10) STUDENTS FROM CRISTO REY DE LA SALLE - A RIGOROUS AND PERSONALIZED COLLEGE PREPARATORY CURRICULUM INTEGRATED WITH A CORPORATE WORK STUDY EXPERIENCE PREPARES HIGH SCHOOL STUDENTS OF LIMITED ECONOMIC MEANS TO SUCCEED IN COLLEGE AND IN LIFE. STUDENTS COMPLETED A REMOTE HIGH SCHOOL WORK STUDY PROGRAM WHERE THEY IMPROVED THEIR PRESENTATION SKILLS AND LEARNED HOW TO PROPERLY SOURCE THEIR FINDINGS. THROUGHOUT THE 23-24 SCHOOL YEAR, SHC TRI-VALLEY INVESTED IN HIGH SCHOOL STUDENT TRAINING IN PARTNERSHIP WITH THE TRI-VALLEY REGIONAL OCCUPATIONAL PROGRAM (ROP). STUDENTS WORKED ON UNITS TO GAIN EXPOSURE AND KNOWLEDGE INTO THE VARIOUS MEDICAL CAREERS, INCLUDING: ROP MEDICAL OCCUPATIONS - 21 STUDENTS ROP NURSING EXPERIENCE - 56 STUDENTS DURING FY24, SHC TRI-VALLEY PROVIDED FUNDING TO I-GATE A NON-PROFIT ORGANIZATION DEDICATED TO BUILDING A THRIVING STARTUP COMMUNITY IN THE TRI-VALLEY. FUNDING SUPPORTS ECONOMIC VITALITY IN THE TRI-VALLEY BY CREATING PROGRAMS TO HELP STARTUPS SUCCEED AND PREPARE THE WORKFORCE NEEDED FOR SCIENCE-BASED STARTUPS.
PART III, LINE 2: PROVISION FOR DOUBTFUL ACCOUNTS OR BAD DEBT EXPENSE ON THE INCOME STATEMENT FOR FISCAL YEAR 2024 WAS $18,380,087, WHICH IS AT CHARGES. BAD DEBT IS BASED ON REMAINING ACCOUNT BALANCE AFTER ANY DISCOUNTS OR PAYMENTS HAVE BEEN APPLIED. SHC TRI-VALLEY DOES NOT RECLASSIFY ANY BAD DEBT TO CHARITY UNLESS THE PATIENT QUALIFIES UNDER THE CHARITY CARE POLICY. A COST TO CHARGE RATIO WAS USED TO DETERMINE COST.
PART III, LINE 3: SHC TRI-VALLEY DOES NOT CALCULATE THE ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY.
PART III, LINE 4: THE PROVISION FOR DOUBTFUL ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL EXPERIENCE AND OTHER COLLECTION INDICATORS. THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR DOUBTFUL ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS.
PART III, LINE 8: THE MEDICARE SHORTFALL OF $93,617,009 REFLECTED ON SCHEDULE H, PART III, SECTION B WAS DETERMINED USING INFORMATION FROM THE ORGANIZATION'S MEDICARE COST REPORT. SHC TRI-VALLEY BELIEVES THIS MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT BECAUSE: 1. ABSENT THE MEDICARE PROGRAM, IT IS LIKELY MANY OF THE INDIVIDUALS WOULD QUALIFY FOR FINANCIAL ASSISTANCE OR OTHER MEANS-BASED GOVERNMENT PROGRAMS, 2. BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS, 3. THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION ON REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUAL, AND 4. THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER FINANCIAL ASSISTANCE OR OTHER COMMUNITY BENEFIT NEEDS.
PART III, LINE 9B: IT IS THE POLICY OF SHC TRI-VALLEY TO FOLLOW THE STANDARDS AND PRACTICES FOR COLLECTION OF PATIENT DEBT IN ACCORDANCE WITH THE REQUIREMENTS OF CALIFORNIA ASSEMBLY BILL 774. SHC TRI-VALLEY HAS A VARIETY OF OPTIONS FOR PATIENTS FACING FINANCIAL HARDSHIP, INCLUDING UNINSURED DISCOUNTING, NO INTEREST PAYMENT ARRANGEMENTS, AND A CHARITY CARE PROGRAM. PATIENTS WHO APPLY FOR CHARITY CARE AND QUALIFY MAY RECEIVE UP TO 100% FINANCIAL ASSISTANCE. SHC TRI-VALLEY WILL SUSPEND ANY AND ALL COLLECTION ACTIONS IF A COMPLETED FINANCIAL ASSISTANCE APPLICATION, INCLUDING ALL REQUISITE SUPPORTING DOCUMENTATION, IS RECEIVED. SHC TRI-VALLEY DOES NOT ALLOW THEIR COLLECTION AGENCIES TO REPORT DEBT TO CREDIT BUREAUS, GARNISH WAGES, OR FILE LIENS ON PRIMARY RESIDENCES.
PART VI, LINE 2: IN ADDITION TO THE CHNA REPORTED IN PART V, SECTION B, SHC TRI-VALLEY ASSESSES COMMUNITY HEALTH NEEDS BY ANALYZING UTILIZATION AND OTHER ADMINISTRATIVE DATA AND BY RECEIVING REGULAR INPUT FROM ITS INDEPENDENT BOARD OF DIRECTORS AND ITS MEDICAL STAFF REGARDING HEALTH ISSUES IN THE COMMUNITY.
PART VI, LINE 3 SHC TRI-VALLEY INTERVIEWS EACH PATIENT/GUARANTOR AND DETERMINE THE CAPABILITY TO MEET HIS/HER FINANCIAL OBLIGATIONS FOR MEDICAL CARE SERVICES PROVIDED BY SHC TRI-VALLEY. THOSE WHO DETERMINED TO BE UNABLE TO MEET THE FINANCIAL OBLIGATION ARE SCREENED FOR POSSIBLE ELIGIBILITY UNDER STATE OR FEDERAL HEALTHCARE PROGRAMS. INDIVIDUALS INELIGIBLE FOR THESE PROGRAMS ARE INTERVIEWED TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE, AS DEFINED IN THE FINANCIAL ASSISTANCE/CHARITY CARE POLICY. SHC TRI-VALLEY ALSO PROVIDES DEDICATED RESOURCES TO PATIENTS THAT APPLY FOR CHARITY CARE AND PROACTIVELY CONDUCTS OUTREACH TO PATIENTS TO INFORM THEM OF THE PROGRAM'S AVAILABILITY AND THEIR POTENTIAL ELIGIBILITY FOR ASSISTANCE. BROCHURES AND SIGNAGE ARE CONSPICUOUSLY DISPLAYED AT ALL CARE DELIVERY LOCATIONS WITH INSTRUCTION ON WHERE TO LOCATE ADDITIONAL INFORMATION ON ELIGIBILITY FOR FINANCIAL ASSISTANCE. FINANCIAL ASSISTANCE APPLICATIONS, AND INSTRUCTIONS ON HOW TO APPLY ARE ALSO AVAILABLE ON THE SHC TRI-VALLEY WEBSITE, VIA MAIL, MYHEALTH (SHC TRI-VALLEY'S ONLINE PATIENT BILLING PLATFORM), ON THE BACK OF ALL PATIENT STATEMENTS, AND IN ALL SHC TRI-VALLEY CARE DELIVERY LOCATIONS.
PART VI, LINE 4: SHC TRI-VALLEY'S PRIMARY SERVICE AREA IS THE TRI-VALLEY. THE TRI-VALLEY ENCOMPASSES THE SUBURBAN CITIES OF LIVERMORE, PLEASANTON, DUBLIN, SAN RAMON, AND DANVILLE IN THE THREE VALLEYS FROM WHICH IT TAKES ITS NAME: AMADOR VALLEY, LIVERMORE VALLEY, AND SAN RAMON VALLEY. DUBLIN, LIVERMORE, AND PLEASANTON ARE IN ALAMEDA COUNTY, AND DANVILLE AND SAN RAMON ARE IN CONTRA COSTA COUNTY. SHC TRI-VALLEY OPERATES FACILITIES IN DUBLIN, LIVERMORE, AND PLEASANTON. THE TRI VALLEY ACCOUNTS FOR THE MAJORITY OF SHC TRI-VALLEY'S INPATIENT DISCHARGES. THE U.S. CENSUS ESTIMATES A POPULATION OF ABOUT 379,000 IN THE TRI-VALLEY. THE AREA IS HIGHLY DIVERSE: THE TWO LARGEST ETHNIC SUBPOPULATIONS ARE WHITE AND ASIAN (51% AND 28%, RESPECTIVELY). THE NON-WHITE POPULATION ACCOUNTS FOR 49% OF THE POPULATION IN THE TRI-VALLEY AREA.
PART VI, LINE 5: SHC TRI-VALLEY HAS PROVIDED HIGH-QUALITY, NOT-FOR-PROFIT HEALTH CARE TO THE TRI-VALLEY AND SURROUNDING COMMUNITIES SINCE 1961. THROUGH HIGHLY SKILLED PHYSICIANS, NURSES AND STAFF AND STATE-OF-THE ART TECHNOLOGY, SHC TRI-VALLEY OFFERS A WIDE RANGE OF HEALTH CARE SERVICES AT ITS LIVERMORE, PLEASANTON AND DUBLIN MEDICAL FACILITIES. SHC TRI-VALLEY IS NOT PUBLICLY OWNED OR OPERATED, NOR IS IT SUPPORTED BY TAXES. SHC TRI-VALLEY REINVESTS ANY PROFITS IT MAKES INTO NEW SERVICES, EQUIPMENT AND FACILITIES. SHC TRI-VALLEY HAS AN 11-MEMBER BOARD OF DIRECTORS. EVERY THREE YEARS, NON-PROFIT HOSPITALS IN CALIFORNIA MUST CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TO IDENTIFY THE GREATEST HEALTH NEEDS AFFECTING THEIR RESPECTIVE COMMUNITIES. THE COMMUNITY BENEFITS REPORT CAN BE FOUND ON OUR WEBSITE AT: ABOUT US: COMMUNITY BENEFITS | STANFORD HEALTH CARE TRI-VALLEY HTTPS://STANFORDHEALTHCARE.ORG/TRI-VALLEY/ABOUT-US/COMMUNITY-BENEFITS.HTML THE FOLLOWING PROGRAMS AND SERVICES FURTHER THE ORGANIZATION'S EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY: PLEASANTON/DUBLIN CAMPUS: SHC TRI-VALLEY CAMPUS IN PLEASANTON, WHICH OPENED IN DECEMBER 1991, IS AN ACUTE CARE COMMUNITY HOSPITAL WITH APPROXIMATELY 114,000 SQUARE FEET OF SPACE THAT PROVIDES A COMPREHENSIVE RANGE OF MEDICAL AND SURGICAL INPATIENT AND OUTPATIENT ACUTE SERVICES, INCLUDING INPATIENT & OUTPATIENT SURGERY & CARDIAC CATHETERIZATION LAB SERVICES, A DIAGNOSTIC IMAGING CENTER, COMPUTERIZED & POSITRON EMISSION TOMOGRAPHY, MAGNETIC RESONANCE IMAGING, AND A WOMEN'S CENTER (MAMMOGRAPHY), CARDIAC CARE & SURGERY, EMERGENCY ROOM, INTENSIVE CARE, OBSTETRICS, PEDIATRICS, PHYSICAL THERAPY, URGENT CARE, LACTATION CENTER, AND COUMADIN CLINIC. THE CURRENT LICENSED BED CAPACITY IS 167 ACUTE CARE BEDS (1 BED IS CURRENTLY IN SUSPENSION), INCLUDING 116 MEDICAL/SURGICAL ACUTE CARE, 15 PERINATAL, 22 CRITICAL CARE, 4 PEDIATRIC, AND 10 INTENSIVE CARE NURSERY BEDS. LIVERMORE CAMPUS: SHC TRI-VALLEY'S CAMPUS IN LIVERMORE IS AN ACUTE CARE COMMUNITY HOSPITAL WITH APPROXIMATELY 125,000 SQUARE FEET OF SPACE. THE CURRENT LICENSED BED CAPACITY IS 75 BEDS IN TOTAL - 35 GENERAL ACUTE CARE, 14 ACUTE PSYCHIATRIC, AND 26 SKILLED NURSING (ALL 75 BEDS ARE CURRENTLY IN SUSPENSION). ADDITIONAL SERVICES INCLUDE AMBULATORY SURGERY, URGENT CARE, LABORATORY, DIAGNOSTIC IMAGING (ULTRASOUND, MAMMOGRAPHY, BONE DENSITOMETRY), RADIOLOGY AND PHYSICAL THERAPY.
PART VI, LINE 6: IN MAY 2015, THE COMPANY (NOW SHC TRI-VALLEY) BECAME AN AFFILIATE OF STANFORD HEALTH CARE (SHC). SHC TRI-VALLEY PARTNERS WITH SHC TO SERVE THE EAST BAY'S TRI-VALLEY REGION IN THE CITIES OF LIVERMORE, DUBLIN, PLEASANTON AND SAN RAMON. SHC TRI-VALLEY ALLOWS SHC TO EXPAND ITS PRESENCE IN THE CRITICAL TRI-VALLEY AREA BY PARTNERING WITH A HIGH QUALITY, HIGH VALUE COMMUNITY HOSPITAL. SHC TRI-VALLEY WILL PARTICIPATE IN ALL THREE OF SHC'S MISSIONS BY PROVIDING SHC'S LEADING EDGE CLINICAL CARE IN THE SHC TRI-VALLEY COMMUNITY, TRAINING FUTURE MEDICAL LEADERS THROUGH RESIDENCY ROTATIONS AND OTHER ACADEMIC PURSUITS, AND PROVIDING THE TRI-VALLEY AREA INCREASED ACCESS TO CLINICAL TRIALS FOR LIFE SAVING TREATMENTS. IN ADDITION, SHC'S GROWING EXPERTISE IN POPULATION AND PRECISION HEALTH WILL BE LEVERAGED TO SERVE THIS COMMUNITY.
PART VI, LINE 7: LIST OF STATES RECEIVING COMMUNITY BENEFIT REPORT: CA
Schedule H (Form 990) 2023
Additional Data


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Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," 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
2023
Open to Public
Inspection
Name of the organization
STANFORD HEALTH CARE TRI-VALLEY
 
Employer identification number
94-1429628
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government
(b) EIN (c) IRC section
(if applicable)
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
noncash assistance
(h) Purpose of grant
or assistance
(1) AXIS COMMUNITY HEALTH INC
5925 W LAS POSITAS
PLEASANTON,CA94588
94-2232394 501(C)(3) 140,000       GENERAL SUPPORT
(2) GOODNESS VILLAGE
1660 FREISMAN RD
LIVERMORE,CA94551
85-2812754 501(C)(3) 52,000       GENERAL SUPPORT
(3) THREE VALLEYS COMMUNITY FOUNDATION
5960 INGLEWOOD DR
PLEASANTON,CA94588
87-1782380 501(C)(3) 30,000       GENERAL SUPPORT
(4) CROSSWINDS CHURCH
1660 FREISMAN RD
LIVERMORE,CA94550
68-0161634 501(C)(3) 10,000       GENERAL SUPPORT
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
4
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2023

Schedule I (Form 990) 2023
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients
(c) Amount of
cash grant
(d) Amount of
noncash assistance
(e) Method of valuation (book,
FMV, appraisal, other)
(f) Description of noncash assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
PART I, LINE 2 PROCEDURES FOR MONITORING USE OF GRANT FUNDS PROGRAM RECIPIENT IS REQUIRED TO SUBMIT DATA ON PERSONS SERVED OR HOW THEY UTILIZED THE FUNDS. DETAIL IS PROVIDED IN OUR COMMUNITY BENEFIT REPORT. GOODNESS VILLAGE REPORTED THEY SPENT FUNDS SPECIFICALLY ON CASE MANAGEMENT SPECIALISTS, AND AXIS PROVIDED NUMBER OF PATIENTS SERVED FOR MENTAL HEALTH SERVICES.
Schedule I (Form 990) 2023



Additional Data


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Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
medium right arrow graphic Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
medium right arrow graphic Attach to Form 990.
medium right arrow graphic Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2023
Open to Public Inspection
Name of the organization
STANFORD HEALTH CARE TRI-VALLEY
 
Employer identification number

94-1429628
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....
2
 
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? .............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2023

Schedule J (Form 990) 2023
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
(i) Base
compensation
(ii) Bonus & incentive
compensation
(iii) Other reportable compensation
1DAVID ENTWISTLE
DIRECTOR
(i)

(ii)
0
-------------
2,106,816
0
-------------
2,322,804
0
-------------
1,488,194
0
-------------
36,300
0
-------------
60,140
0
-------------
6,014,254
0
-------------
680,883
2QUINN MCKENNA
DIRECTOR
(i)

(ii)
0
-------------
1,319,528
0
-------------
1,002,036
0
-------------
591,804
0
-------------
36,300
0
-------------
45,884
0
-------------
2,995,552
0
-------------
304,340
3LINDA HOFF
DIRECTOR
(i)

(ii)
0
-------------
1,102,720
0
-------------
795,618
0
-------------
430,206
0
-------------
173,945
0
-------------
23,874
0
-------------
2,526,363
0
-------------
112,597
4RICHARD SHUMWAY
PRESIDENT/CEO
(i)

(ii)
830,563
-------------
0
649,187
-------------
0
88,445
-------------
0
242,342
-------------
0
41,780
-------------
0
1,852,317
-------------
0
245,280
-------------
0
5KYLE WICHELMANN
CFO
(i)

(ii)
413,834
-------------
0
115,863
-------------
0
3,846
-------------
0
87,349
-------------
0
37,256
-------------
0
658,148
-------------
0
0
-------------
0
6TRACEY LEWIS TAYLOR
COO (UNTIL 05/24)
(i)

(ii)
427,983
-------------
0
119,010
-------------
0
1,320
-------------
0
19,800
-------------
0
31,808
-------------
0
599,921
-------------
0
0
-------------
0
7MONICA DAVILA
INTERIM COO
(i)

(ii)
332,336
-------------
0
70,189
-------------
0
1,161
-------------
0
60,712
-------------
0
41,692
-------------
0
506,090
-------------
0
0
-------------
0
8MANOJ SASTRY
INTERIM CAO/VP MKT DEVL
(i)

(ii)
329,231
-------------
0
70,472
-------------
0
1,153
-------------
0
55,277
-------------
0
41,687
-------------
0
497,820
-------------
0
0
-------------
0
9JENNIFER SAAVEDRA
REGISTERED NURSE II
(i)

(ii)
170,370
-------------
0
1,500
-------------
0
233,053
-------------
0
13,574
-------------
0
39,949
-------------
0
458,446
-------------
0
0
-------------
0
10PAUL MUSER
REGISTERED NURSE II
(i)

(ii)
161,843
-------------
0
1,500
-------------
0
222,822
-------------
0
17,441
-------------
0
34,580
-------------
0
438,186
-------------
0
0
-------------
0
11COLE MENDENHALL
REGISTERED NURSE II
(i)

(ii)
139,970
-------------
0
1,500
-------------
0
251,496
-------------
0
8,986
-------------
0
34,580
-------------
0
436,532
-------------
0
0
-------------
0
12CHRISTOPHER LYONS
VP HUMAN RESOURCES
(i)

(ii)
316,650
-------------
0
66,410
-------------
0
1,849
-------------
0
33,425
-------------
0
13,901
-------------
0
432,235
-------------
0
0
-------------
0
13HIRUT TRUNEH
INTERIM CNO (FROM 03/24)
(i)

(ii)
299,056
-------------
0
54,382
-------------
0
0
-------------
0
39,128
-------------
0
29,409
-------------
0
421,975
-------------
0
0
-------------
0
14JOHN YEE MD
VP CLINICAL INITIATIVES
(i)

(ii)
276,322
-------------
0
59,735
-------------
0
6,039
-------------
0
42,250
-------------
0
30,189
-------------
0
414,535
-------------
0
0
-------------
0
15NICHOLE THOMAS
REGISTERED NURSE II
(i)

(ii)
165,143
-------------
0
1,850
-------------
0
224,029
-------------
0
9,396
-------------
0
1,659
-------------
0
402,077
-------------
0
0
-------------
0
16MATTHEW WOLDEN
VP OF OPERATIONS
(i)

(ii)
264,698
-------------
0
0
-------------
0
12,626
-------------
0
12,910
-------------
0
16,758
-------------
0
306,992
-------------
0
0
-------------
0
17DIANE GRUNSKY
FORMER SECRETARY
(i)

(ii)
143,738
-------------
0
6,500
-------------
0
0
-------------
0
1,707
-------------
0
16,425
-------------
0
168,370
-------------
0
0
-------------
0
18DAVID SVEC MD
CMO
(i)

(ii)
0
-------------
245,923
0
-------------
356,088
0
-------------
140
0
-------------
25,950
0
-------------
52,921
0
-------------
681,022
0
-------------
0
19AARON SALYAPONGSE MD
DIRECTOR
(i)

(ii)
0
-------------
341,482
0
-------------
772,292
0
-------------
0
0
-------------
21,875
0
-------------
46,442
0
-------------
1,182,091
0
-------------
0
20RON DALMAN MD
DIRECTOR
(i)

(ii)
0
-------------
523,315
0
-------------
311,161
0
-------------
0
0
-------------
33,000
0
-------------
47,815
0
-------------
915,291
0
-------------
0
21CHRISTOPHER SHARP MD
DIRECTOR
(i)

(ii)
0
-------------
348,075
0
-------------
197,427
0
-------------
280
0
-------------
33,000
0
-------------
37,480
0
-------------
616,262
0
-------------
0
22JACQUELINE STEIN
FORMER SECRETARY
(i)

(ii)
144,627
-------------
0
1,500
-------------
0
406
-------------
0
7,232
-------------
0
1,072
-------------
0
154,837
-------------
0
0
-------------
0
Schedule J (Form 990) 2023

Schedule J (Form 990) 2023
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
SCHEDULE J, PART I, LINE 4B STANFORD HEALTH CARE ("SHC"), A RELATED ORGANIZATION, PROVIDES ALL SENIOR EXECUTIVES WITH A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) TO SUPPLEMENT THEIR RETIREMENT BENEFITS. FOR EACH CALENDAR YEAR, A HYPOTHETICAL ACCOUNT IS ESTABLISHED FOR EACH PARTICIPANT AND CREDITED WITH AN AMOUNT EQUAL TO A PERCENTAGE OF BASE SALARY (DEPENDING ON THE INDIVIDUAL'S POSITION) AS OF THE LAST DAY OF EACH QUARTER. THE COMPENSATION COMMITTEE MAY DETERMINE THAT CREDITS SHALL BE MADE IN ADDITION TO THOSE ABOVE IN ITS SOLE DISCRETION. A PARTICIPANT BECOMES VESTED IN EACH CALENDAR YEAR ACCOUNT ON THE FIRST BUSINESS DAY OF JANUARY FOLLOWING THE SECOND CALENDAR YEAR IN WHICH THE ACCOUNT WAS ESTABLISHED (OR, IF LATER, THE DATE ON WHICH THE PARTICIPANT COMPLETES TWO FULL YEARS OF PARTICIPATION). THE PARTICIPANT BECOMES FULLY VESTED IN HIS OR HER ACCOUNTS UNDER THE SERP UPON THE EARLIEST OF (A) DISCHARGE FROM EMPLOYMENT WITHOUT CAUSE; (B) ENTITLEMENT TO LONG-TERM DISABILITY INCOME BENEFITS; (C) ATTAINMENT OF AGE OF 60 WHILE EMPLOYED OR IF LATER, THE PARTICIPANT'S COMPLETION OF TWO FULL YEARS OF PARTICIPATION; (D) COMPLETION OF SEVEN YEARS AS AN ELIGIBLE EMPLOYEE; OR (E) DEATH. THE FOLLOWING AMOUNTS BECAME VESTED AND WERE PAID TO THE FOLLOWING INDIVIDUALS IN CALENDAR YEAR 2023: DAVID ENTWISTLE $ 1,073,415 QUINN MCKENNA $ 479,274 LINDA HOFF $ 117,206 FOR CERTAIN INDIVIDUALS LISTED ON SCHEDULE J, PART II, AMOUNTS CREDITED UNDER THE PLAN ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C). AMOUNTS CREDITED AND DISCLOSED ON THE FORM 990 IN PRIOR YEARS THAT VESTED AND WERE PAID IN CALENDAR 2023 ARE REPORTED IN COLUMN (F). SHC TRI-VALLEY'S PRESIDENT PARTICIPATES IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) TO SUPPLEMENT HIS RETIREMENT BENEFITS. UNDER THE PLAN, A HYPOTHETICAL ACCOUNT IS ESTABLISHED FOR THE PARTICIPANT AND CREDITED WITH AN AMOUNT EQUAL TO A PERCENTAGE OF BASE SALARY AS OF THE LAST DAY OF EACH QUARTER. THE COMPENSATION COMMITTEE MAY DETERMINE THAT CREDITS SHALL BE MADE IN ADDITION TO THOSE ABOVE IN ITS SOLE DISCRETION. THE PARTICIPANT BECOMES VESTED IN EACH CALENDAR YEAR ACCOUNT ON THE FIRST BUSINESS DAY OF JANUARY FOLLOWING THE SECOND CALENDAR YEAR IN WHICH THE ACCOUNT WAS ESTABLISHED (OR, IF LATER, THE DATE ON WHICH THE PARTICIPANT COMPLETES TWO FULL YEARS OF PARTICIPATION). THE PARTICIPANT BECOMES FULLY VESTED IN HIS OR HER ACCOUNTS UNDER THE SERP UPON THE EARLIEST OF (A) DISCHARGE FROM EMPLOYMENT WITHOUT CAUSE; (B) ENTITLEMENT TO LONG-TERM DISABILITY INCOME BENEFITS; (C) ATTAINMENT OF AGE OF 60 WHILE EMPLOYED OR IF LATER, THE PARTICIPANT'S COMPLETION OF TWO FULL YEARS OF PARTICIPATION (D) COMPLETION OF SEVEN YEARS AS AN ELIGIBLE EMPLOYEE; OR (E) DEATH. THE FOLLOWING AMOUNT BECAME VESTED AND WAS PAID TO RICHARD SHUMWAY IN CALENDAR YEAR 2023: $64,325. AMOUNTS CREDITED UNDER THE PLAN ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C).
SCHEDULE J, PART I, LINE 7 EIGHT EXECUTIVES RECEIVED A BONUS THAT WAS APPROVED BY SENIOR MANAGEMENT.
SCHEDULE J, PART II, COLUMN B(III) OTHER REPORTABLE COMPENSATION IN SCHEDULE J, PART II, COLUMN (III) INCLUDES ACCRUED VACATION PAY OUT, GROUP TERM LIFE, SERP DISTRIBUTION, IMPUTED INTEREST FOR MORTGAGE LOAN FORGIVENESS, AND ADDITIONAL SHIFT WORK PAY.
SCHEDULE J, PART II DIRECTORS ARE NOT COMPENSATED IN THEIR CAPACITY AS DIRECTORS OF SHC TRI-VALLEY. HOWEVER, THE INDIVIDUALS LISTED WERE ALSO EMPLOYEES OF RELATED ORGANIZATIONS, POSITIONS FOR WHICH THEY RECEIVED COMPENSATION AS REPORTED IN PART II.
Schedule J (Form 990) 2023

Additional Data


Software ID:  
Software Version:  
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.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2023
Open to Public
Inspection
Name of the organization
STANFORD HEALTH CARE TRI-VALLEY
 
Employer identification number

94-1429628
Return Reference Explanation
FORM 990, PART I, LINE 1 STANFORD HEALTH CARE TRI-VALLEY'S MISSION STATEMENT: FOR THE BENEFIT OF OUR PATIENTS AND THE COMMUNITY WE SERVE, OUR MISSION IS TO CARE, TO EDUCATE, AND TO DISCOVER. VISION STATEMENT: HEALING HUMANITY THROUGH SCIENCE AND COMPASSION, ONE PATIENT AT A TIME.
FORM 990, PART III, LINE 4A SHC TRI-VALLEY'S OPERATIONAL SERVICES INCLUDE INPATIENT MEDICAL, SURGICAL AND MATERNAL & CHILD HEALTH, EMERGENCY, DIAGNOSTIC AND THERAPEUTIC, AMBULATORY PROCEDURAL AND ADDITIONAL HEALTH CARE SERVICES. CARE IS PROVIDED TO ALL INCLUDING THOSE INSURED BY GOVERNMENT, COMMERCIAL OR OCCUPATIONAL HEALTH COVERAGES, SELF-PAY PATIENTS AND PATIENTS WHO MEET CERTAIN CRITERIA UNDER THE CHARITY-CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. ANY PROFITS MADE FROM OPERATIONS ARE INVESTED INTO NEW FACILITIES, EQUIPMENT AND SERVICES OR COMMUNITY BENEFIT PROGRAMS. STANFORD HEALTH CARE TRI-VALLEY'S ANNUAL COMMUNITY BENEFIT INVESTMENT FOCUSES ON IMPROVING THE HEALTH OF THE COMMUNITY'S MOST VULNERABLE POPULATIONS, INCLUDING THE MEDICALLY UNDERSERVED, LOW-INCOME, AND POPULATIONS AFFECTED BY HEALTH DISPARITIES. THIS INCLUDED HEALTH RESEARCH, HEALTH EDUCATION AND TRAINING, AND PROVIDING ESSENTIAL SERVICES FOR THOSE MOST IN NEED IN OUR COMMUNITIES. AS PART OF SHC TRI-VALLEY'S SUPPORT FOR ITS COMMUNITY PARTNERS AND OTHER COMMUNITY-BASED AGENCIES, SHC TRI-VALLEY CONDUCTED A VARIETY OF ACTIVITIES FOR COMMUNITY MEMBERS, RANGING FROM EDUCATION AND SUPPORT TO PERSONS WITH CHRONIC CONDITIONS, MEALS TO THE DISABLED AND SENIORS AND REDUCED-COST WELLNESS PROGRAMS FOR ECONOMICALLY DISADVANTAGED MEMBERS OF THE COMMUNITY. ACTIVITIES FOR VULNERABLE POPULATIONS SHC TRI-VALLEY PROVIDED FUNDING TO SUPPORT ALAMEDA COUNTRY'S HEALING HEARTS EVENT FOR SUICIDE PREVENTION. THE EVENT IS FOCUSED ON RAISING AWARENESS OF THE TRAGEDY OF SUICIDE, REDUCING THE STIGMA ASSOCIATED WITH DEPRESSION AND MENTAL ILLNESS, EDUCATING THE COMMUNITY ABOUT AVAILABLE SERVICES, SUPPORTING LOCAL SUICIDE PREVENTION PROGRAMS, AND PROVIDING A SAFE PLACE TO HEAL FOR THOSE WHO HAVE LOST LOVED ONES TO SUICIDE. PERSONS SERVED: 228 SHC TRI-VALLEY PROVIDED FUNDING TO THREE VALLEYS COMMUNITY FUND FOR MENTAL HEALTH & WELLNESS, HEALTH EQUITY & ACCESS, AND ENVIRONMENTAL HEALTH & SUSTAINABILITY. MENTAL HEALTH & WELLNESS: ADDRESSES THE CONTINUED NEED FOR MENTAL HEALTH SUPPORT AND SEEKS TO STRENGTHEN MENTAL HEALTH SERVICES. HEALTH EQUITY & ACCESS: DISMANTLES BARRIERS TO HEALTHCARE ACCESS FOR TRADITIONALLY UNDERSERVED GROUPS, INCLUDING PERSONS OF COLOR, NON-ENGLISH SPEAKING COMMUNITIES, SENIORS, PEOPLE WITH DISABILITIES, LOW-INCOME HOUSEHOLDS, UNHOUSED, AND IMMIGRANT POPULATION. ENVIRONMENTAL HEALTH & SUSTAINABILITY: BOOSTS ENVIRONMENTAL STEWARDSHIP AND IMPROVES BOTH ENVIRONMENTAL AND PUBLIC HEALTH THROUGH EDUCATION, OUTREACH, AND WORKFORCE DEVELOPMENT IN THE GREEN SECTOR. SHC TRI-VALLEY SPONSORED A ONE-DAY EVENT WITH ALAMEDA COUNTY VETERANS STAND DOWN TO SUPPORT HOMELESS OR AT-RISK VETERANS BY PROVIDING THE NECESSARY SOCIAL AND HUMAN SERVICES TO HELP THEM IMPROVE THEIR LIVES. IN ADDITION TO SNACKS AND LUNCH, RESOURCES FOR VETERANS, INCLUDING PHYSICAL AND MENTAL HEALTH CARE, DENTAL CHECKUPS, HAIRCUTS, AND MUCH MORE WERE OFFERED AT THIS EVENT. FOR MEALS ON WHEELS, SHC TRI-VALLEY PREPARED MORE THAN 34,420 MEALS (MORE THAN 90 MEALS PER DAY, 5 DAYS PER WEEK) 800 PEOPLE ARE SERVED, FOR HOMEBOUND SENIORS IN THE FOLLOWING ALAMEDA COUNTY CITIES, PLEASANTON, LIVERMORE, DUBLIN AND SUNOL. THESE HOT MEAL PROGRAMS PROVIDE LOCAL SENIORS WITH THE NUTRITION CRITICAL TO THEIR HEALTH AND WELL-BEING. SHC TRI-VALLEY ALSO PROVIDED OFFICE SPACE TO SPECTRUM, THE NONPROFIT ORGANIZATION IN CHARGE OF ORGANIZING THE MEALS ON WHEELS PROGRAM IN THE TRI-VALLEY AREA. SHC TRI-VALLEY SUPPORTED CAPE'S PROVISION OF MEALS FOR PRESCHOOL-AGED CHILDREN BY PREPARING ALL THE MEALS. CAPE, INC.'S PRIMARY FOCUS IS PROVIDING THE HIGHEST QUALITY EARLY CHILDHOOD DEVELOPMENT SERVICES THAT MEET THE NEEDS OF LOW-INCOME CHILDREN AND THEIR FAMILIES INCLUDING HEALTH AND NUTRITION. SERVED OVER 150 PRESCHOOLERS. PROVIDED FUNDING TO SUPPORT OPERATION CRANBERRY SAUCE (OCS). OCS FOOD PACKAGES FEED A FAMILY OF FIVE FOR A THANKSGIVING MEAL. EACH LOW-INCOME FAMILY RECEIVED ONE BOX OF GROCERIES THAT INCLUDED STAPLES AND NONPERISHABLE ITEMS AND A FROZEN TURKEY. FOOD PACKAGES WERE PROVIDED TO APPROXIMATELY 9,000 LOW-INCOME FAMILY MEMBERS IN LIVERMORE, PLEASANTON, DUBLIN, SAN LEANDRO, CASTRO VALLEY, HAYWARD, AND OAKLAND. PERSONS SERVED: APPROX. 9,000 PROVIDED EXPERTS TO ASSIST UNINSURED, LOW-INCOME PATIENTS RESEARCH THEIR HEALTH CARE OPTIONS. SERVICES PROVIDED AT NO COST BY MEDDATA INVOLVE HELPING INDIVIDUALS RESEARCH ELIGIBILITY REQUIREMENTS, IDENTIFY APPROPRIATE HEALTH INSURANCE PROGRAMS, COMPLETE APPLICATIONS, COMPILE REQUIRED DOCUMENTATION, AND FOLLOW UP WITH COUNTY CASE MANAGERS. THIS SERVICE ASSISTS ELIGIBLE PATIENTS IN OBTAINING COVERAGE FOR MEDICAL NECESSITIES, SUCH AS HOSPITAL CARE, PRESCRIPTION DRUGS, AND HOME HEALTH CARE. PROVIDED FUNDING AND RESOURCES FOR PATIENTS THAT HAVE LIMITED OR NO ABILITY TO PAY FOR NECESSARY MEDICAL AND NONMEDICAL SERVICES THROUGH THE SOCIAL WORK AND CASE MANAGEMENT DEPARTMENT. SERVICES INCLUDE TRANSPORTATION, MEDICATIONS, CLOTHING, AND MEAL ASSISTANCE. PERSONS SERVED: 2,026
FORM 990, PART III, LINE 4A (CONT.) SHC TRI-VALLEY PROVIDED FUNDS FOR A LICENSED MARRIAGE AND FAMILY THERAPIST (MFT) FOR AXIS COMMUNITY HEALTH. THIS THERAPIST INCREASED CAPACITY TO SERVE TRI-VALLEY RESIDENTS AT AXIS' CLINICAL SITE. THE ADDITIONAL COUNSELOR HAS HELPED TO ALLEVIATE THE DIRE NEED FOR MORE MENTAL HEALTH SERVICES IN THE COMMUNITY. IN ADDITION, WAIT TIMES FOR MENTAL HEALTH SERVICES APPOINTMENTS AT THE CLINIC HAVE BEEN REDUCED. A TOTAL OF 1,047 MENTAL HEALTH VISITS WERE PROVIDED TO THE UNINSURED. SHC TRI-VALLEY SUPPORTED SAFE LANDING, AN ALAMEDA COUNTY OUTREACH AND TREATMENT PROGRAM. THE DROP-IN CENTER IS LOCATED ON THE GROUNDS OF SANTA RITA JAIL FOR PEOPLE WITH MENTAL ILLNESS, CO-OCCURRING CONDITIONS, AND SUBSTANCE USE DISORDERS, ASSISTING THEM WITH IMMEDIATE NEEDS AS THEY ARE RELEASED FROM JAIL. THE DROP-IN CENTER PROVIDES A SAFE, COMFORTABLE, NON-THREATENING, TEMPORARY STOP-OVER AS NEXT OPTIONS ARE CONSIDERED, AND PROVIDES ASSISTANCE/CONNECTION WITH: LOCATING BOTH IMMEDIATE AND LONG-TERM HOUSING, MEDICATION, GRIEF COUNSELING AND CRISIS COUNSELING, REFERRALS TO FURTHER MENTAL HEALTH AND/OR SUBSTANCE USE SERVICES, CONNECTION TO TRANSPORTATION (BART, BUS, CAB), REFRESHMENTS AND CHANGE OF CLOTHES. TELEPHONE AND/OR INTERNET TO LINE UP TRANSPORTATION AND OTHER POST-RELEASE NECESSITIES. PERSONS SERVED: 10,906 SHC TRI-VALLEY PROVIDED GRANT FUNDING AT GOODNESS VILLAGE FOR A CASE MANAGEMENT SPECIALIST. GOODNESS VILLAGE IS A TINY HOME COMMUNITY THAT PROVIDES AFFORDABLE AND PERMANENT HOUSING OPTIONS IN A SUPPORTIVE COMMUNITY FOR PEOPLE TRANSITIONING OUT OF CHRONIC HOMELESSNESS. PERSONS SERVED: 33 SHC TRI-VALLEY PROVIDED A WIDE VARIETY OF RESOURCES AND SERVICES TO THE BROADER COMMUNITY REGARDING GENERAL HEALTH TOPICS, AS WELL AS MATERNAL/CHILD EDUCATION AND CARDIAC INFORMATION AND EDUCATION. THESE ALSO INCLUDED LECTURES. SHC TRI-VALLEY PROVIDED FREE, NONMEDICAL SUPPORT SERVICES TO CANCER PATIENTS, FAMILY MEMBERS, AND CAREGIVERS REGARDLESS OF WHERE PATIENTS RECEIVE TREATMENT. SERVICES PROVIDED INCLUDE SUPPORT GROUPS, HEALTH EDUCATION CLASSES, SEMINARS, SYMPOSIA, AND HEALING TOUCH SUPPORTIVE CARE. SHC TRI-VALLEY PROVIDED HERS FOUNDATION SPONSORSHIP FUNDS TO SUPPORT ALL INDIVIDUALS HEALING FROM BREAST CANCER BY PROVIDING POST-SURGICAL PRODUCTS AND SERVICES, REGARDLESS OF FINANCIAL STATUS. HERS STANDS FOR HOPE, EMPOWERMENT, RENEWAL, AND SUPPORT. SHC TRI-VALLEY PROVIDED FUNDS TO SUPPORT CULINARY ANGELS, A VOLUNTEER, DONATION-BASED ORGANIZATION THAT PROVIDES NUTRIENT-RICH MEALS AND NUTRITION EDUCATION TO PEOPLE GOING THROUGH A SERIOUS HEALTH CHALLENGE. MEALS ARE DELIVERED FREE-OF-CHARGE THROUGHOUT LIVERMORE, DUBLIN AND PLEASANTON. SHC TRI-VALLEY PROVIDED FUNDING TO VARIOUS SCHOOLS AND NONPROFIT ORGANIZATIONS IN THE COMMUNITY TO HELP PROMOTE HEALTHY EATING AND ACTIVE LIFESTYLE PROGRAMS AND STEM EDUCATION. PROVIDED FIRST AID AT LOCAL COMMUNITY EVENTS SUCH AS THE LIVERMORE RODEO AND LITTLE LEAGUE WORLD SERIES. PROVIDED FUNDING IN SUPPORT OF THE CITY OF LIVERMORE'S ANNUAL COMMUNITY SERVICE DAY EVENT, AS WELL AS PROVIDED VOLUNTEER SUPPORT BENEFITING JUNCTION AVENUE SCHOOL, AN UNDERSERVED SCHOOL WITHIN THE LIVERMORE COMMUNITY. STANFORD HEALTH CARE TRI-VALLEY REMAINED COMMITTED TO SUPPORTING THE BROAD COMMUNITY NEEDS EMERGING FROM THE COVID-19 PANDEMIC. THROUGH PARTNERSHIP WITH FEDERAL, STATE, AND LOCAL GOVERNMENT AND PUBLIC HEALTH AGENCIES, OTHER HEALTH CARE PROVIDERS, AND LOCAL COMMUNITY-BASED ORGANIZATION. THE COVID-19 RESPONSE INVESTMENT AMOUNTED TO OVER $17 MILLION FROM FY20 THROUGH FY24. SPECIALIZED HEALTH CARE WORKFORCE TRAINING - SEE SCHEDULE H, PART VI SUPPLEMENTAL INFORMATION RELATED TO PART II, LINE 8.
FORM 990, PART VI, SECTION A, LINE 2 THE FOLLOWING INDIVIDUALS ARE EMPLOYEES OF STANFORD HEALTH CARE: DAVID ENTWISTLE LINDA HOFF QUINN MCKENNA THE FOLLOWING INDIVIDUALS ARE EMPLOYEES OF STANFORD UNIVERSITY: TOPHER SHARP MD RON DALMAN MD AARON SALYAPONGSE MD DAVID SVEC MD THE FOLLOWING INDIVIDUALS ARE BOARD MEMBERS AT STANFORD HEALTH CARE: DAVID ENTWISTLE KAYE FOSTER THE FOLLOWING INDIVIDUALS ARE VOTING BOARD MEMBERS AT SUMIT HOLDING INTERNATIONAL, LLC DAVID ENTWISTLE LINDA HOFF THE FOLLOWING INDIVIDUALS ARE VOTING BOARD MEMBERS AT SUMIT INSURANCE COMPANY, LTD.: DAVID ENTWISTLE LINDA HOFF THE FOLLOWING INDIVIDUALS ARE CLASS A SUBSCRIBER VOTING MEMBERS AT THE PROFESSIONAL EXCHANGE ASSURANCE COMPANY: (AS OF 9/1/2023) DAVID ENTWISTLE LINDA HOFF THE FOLLOWING INDIVIDUALS ARE MANAGERS AT STANFORD PET-CT LLC: DAVID ENTWISTLE QUINN MCKENNA THE FOLLOWING INDIVIDUALS ARE DIRECTORS AT LUCILE SALTER PACKARD CHILDREN'S HOSPITAL: DAVID ENTWISTLE
FORM 990, PART VI, SECTION A, LINE 6 STANFORD HEALTH CARE IS THE SOLE MEMBER OF SHC TRI-VALLEY.
FORM 990, PART VI, SECTION A, LINE 7A STANFORD HEALTH CARE, AS THE SOLE MEMBER OF SHC TRI-VALLEY, APPOINTS ALL CLASS "B" DIRECTORS, AND APPROVES APPOINTMENT OF CLASS "A" DIRECTORS TO THE SHC TRI VALLEY BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING POWERS ARE RESERVED TO STANFORD HEALTH CARE, AS THE SOLE MEMBER OF SHC TRI-VALLEY: (A) APPOINTMENT AND REMOVAL OF ALL SENIOR LEADERSHIP AND ENGAGEMENT OF STANFORD UNIVERSITY TO PROVIDE LEGAL AND INTERNAL AUDIT SERVICES TO THE CORPORATION; (B) SELECTION OF THE AUDITORS OF THE CORPORATION; (C) AMENDMENT OF THESE BYLAWS, EXCEPT AS PROVIDED IN ARTICLE X; (D) APPROVAL OF THE INCURRENCE OF DEBT BY THE CORPORATION OTHER THAN DEBT PROVIDED FOR IN AN APPROVED CAPITAL BUDGET APPROVED BY THE MEMBER; (E) APPROVAL OF OPERATING AND CAPITAL BUDGETS OF THE CORPORATION; AND (F) APPROVAL OF STRATEGIC PLANS THAT HAVE BEEN DEVELOPED BY MANAGEMENT AND SUBMITTED FOR APPROVAL TO THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 11B THE FINANCE DEPARTMENT REVIEWS THE FORM 990 FOR ACCURACY, WITH INPUT FROM COMMUNITY BENEFITS DEPARTMENT PRIMARILY FOR SCHEDULE H. PRIOR TO FILING THE RETURN WITH THE INTERNAL REVENUE SERVICE, A COMPLETE COPY OF THE FORM 990 IS SENT ELECTRONICALLY TO EACH MEMBER OF THE BOARD OF DIRECTORS FOR THEIR REVIEW. THE CHIEF FINANCIAL OFFICER REVIEWS THE FORM 990 WITH THE AUDIT COMMITTEE AND INVITES QUESTIONS. FOLLOWING THIS REVIEW, A FULL COPY OF THE FINAL RETURN IS PROVIDED TO EACH MEMBER OF THE BOARD OF DIRECTORS PRIOR TO FILING. ONCE THESE STEPS ARE COMPLETE, THE RETURN IS FILED WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12C OFFICERS, DIRECTORS AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE AN INITIAL CONFLICT-OF-INTEREST DISCLOSURE STATEMENT ("DISCLOSURE STATEMENT") WITHIN 30 DAYS OF BEGINNING SERVICE AT SHC TRI-VALLEY. ADDITIONALLY, AN UPDATED DISCLOSURE STATEMENT IS REQUIRED THEREAFTER ON AN ANNUAL BASIS. FURTHERMORE, OFFICERS, DIRECTORS AND KEY EMPLOYEES ARE REQUIRED TO UPDATE THEIR DISCLOSURE STATEMENT WITHIN TEN (10) BUSINESS DAYS OF A MATERIAL CHANGE IN THEIR SITUATIONS THAT MAY CREATE AN ACTUAL OR PERCEIVED CONFLICT-OF-INTEREST. A DISCLOSURE THAT APPEARS TO BE A CONFLICT WILL BE RESOLVED BY A MUTUAL AGREEABLE PLAN WITH THE VICE PRESIDENT OF HUMAN RESOURCES THAT OUTLINES THE STEPS THE OFFICER, DIRECTOR OR KEY EMPLOYEE MUST TAKE TO RECTIFY THE CONFLICT. IN MATTERS THAT ARE UNCLEAR OR QUESTIONABLE, THE OFFICE OF CHIEF COMPLIANCE OFFICER WILL BE CONSULTED FOR A RULING. IF FURTHER INQUIRY IS NECESSARY THE OFFICE OF THE GENERAL COUNSEL WILL DETERMINE THE APPROPRIATE COURSE OF ACTION.
FORM 990, PART VI, SECTION B, LINES 15A & 15B SHC TRI-VALLEY UTILIZES THE SERVICES OF WILLIS TOWERS WATSON FOR COMPENSATION BENCHMARKING, ANALYSIS, AND REPORTING. THE BOARD OF DIRECTORS HAS A COMPENSATION & WORKFORCE SUB-COMMITTEE WHO REVIEWS THE RESULTS OF THE COMPENSATION REVIEW AND IS ASSURED THAT TOTAL COMPENSATION IS CONSISTENT WITH THE MARKET. THIS PROCESS WAS LAST PERFORMED IN NOVEMBER 2023.
FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING/ORGANIZING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCES EQUITY TRANSFER $ 25,211,676 REVERSAL OF PREVIOUSLY ACCRUED INCOME $ 722,074 --------------- OTHER CHANGES IN NET ASSETS OR $ 25,933,750 FUND BALANCES
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2023


Additional Data


Software ID:  
Software Version:  
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.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2023
Open to Public Inspection
Name of the organization
STANFORD HEALTH CARE TRI-VALLEY
 
Employer identification number

94-1429628
Part I
Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income


(e)
End-of-year assets


(f)
Direct controlling
entity

(1) TRI-VALLEY AMBULATORY SURGERY CENTERLLC
5555 W LAS POSITAS BLVD
PLEASANTON,CA94588
84-3305341
HEALTHCARE CA 0 0 TRI-VALLEY
 










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


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


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

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled entity?
Yes No
(1)THE BRD OF TRUST LELAND STANF JR UNIV
485 BROADWAY MAILCODE 8838

REDWOOD CITY,CA94063
94-1156365
EDUCATION CA 501(C)(3) 2 NA
 
 
No
(2)FUNDACION STANFORD UNIVERSITY EN CHILE
AV CONDELL 189 PROVIDENCIA
SANTIAGO    
CI
EDUCATION CI 501(C)(3) N/A STANFORD
 
Yes
 
(3)JAEDAN BUPIN STANFORD CENTER IN THE REPU
 
 
RESEARCH KS 501(C)(3) N/A STANFORD
 
Yes
 
(4)LUCILE PACKARD FOUNDATION FOR CHILDREN'S
400 HAMILTON AVENUE SUITE 340

PALO ALTO,CA94301
77-0440090
HEALTHCARE CA 501(C)(3) 7 LPCH
 
Yes
 
(5)LUCILE SALTER PACKARD CHILDREN'S HOSPITA
725 WELCH ROAD MC 5553

PALO ALTO,CA94304
77-0003859
HEALTHCARE CA 501(C)(3) 3 STANFORD
 
Yes
 
(6)PACKARD CHILDREN'S HEALTH ALLIANCE
725 WELCH ROAD MC5551

PALO ALTO,CA94304
32-0359189
HEALTHCARE CA 501(C)(3) 3 LPCH
 
Yes
 
(7)SHR HOLDINGS INC
485 BROADWAY MAILCODE 8838

REDWOOD CITY,CA94063
94-3187167
REAL ESTATE CA 501(C)(25) N/A STANFORD
 
Yes
 
(8)STANFORD FACULTY CLUB
PO BOX 7229

STANFORD,CA94309
94-1187089
FAC INTERACT. CA 501(C)(7) N/A STANFORD
 
Yes
 
(9)STANFORD FEDERAL CREDIT UNION
1860 EMBARCADERO RD

PALO ALTO,CA94303
94-1492212
CREDIT UNION CA 501(C)(1) N/A STANFORD
 
Yes
 
(10)STANFORD HABITAT CONSERVATION BOARD
415 BROADWAY

REDWOOD CITY,CA94063
46-1882243
CONSERVATION CA 501(C)(3) 7 STANFORD
 
Yes
 
(11)STANFORD HEALTH CARE
300 PASTEUR DRIVE MC 5555

STANFORD,CA94305
94-6174066
HEALTHCARE CA 501(C)(3) 3 STANFORD
 
Yes
 
(12)STANFORD PROGRAMME (CAPE TOWN) NPC
WAVERLY BUSINESS PARK BLDG 11
CAPE TOWN    
SF
EDUCATION SF 501(C)(3) N/A STANFORD
 
Yes
 
(13)STANFORD UNIVERSITY BOOKSTORE
505 BROADWAY 6TH FLOOR MC1065

REDWOOD CITY,CA94063
94-0894150
SUPPORT CA 501(C)(3) 12A, I STANFORD
 
Yes
 
(14)SU EMP BEN TRUST POST RETEMPYNT BEN
485 BROADWAY MAILCODE 8838

REDWOOD CITY,CA94063
94-3246199
BENEFITS CA 501(C)(9) N/A STANFORD
 
Yes
 
(15)THE DUDLEY E CHAMBERS FOUNDATION
JP MORGAN CHASE PO BOX 3038

MILWAUKEE,WI53201
38-6841793
SUPPORT NY 501(C)(3) 12D, III-O STANFORD
 
Yes
 
(16)THE FREIDENRICH SUPPORT FOUNDATION
485 BROADWAY MAILCODE 8838

REDWOOD CITY,CA94063
30-0519583
SUPPORT CA 501(C)(3) 12A, I STANFORD
 
Yes
 
(17)THE HONG KONGSU CHARITABLE TRUST
1401 CAROLINE CENTER 28 PING ROAD
CAUSEWAY    
HK
98-6078093
SUPPORT HK 501(C)(3) N/A STANFORD
 
Yes
 
(18)THE STANFORD TRUST
65 HIGH STREET
OXFORD   OX1 46L
UK
SUPPORT UK 501(C)(3) N/A STANFORD
 
Yes
 
(19)UNIVERSITY HEALTHCARE ALLIANCE
7999 GATEWAY BLVD STE 300

NEWARK,CA94560
94-3192446
HEALTHCARE CA 501(C)(3) 3 SHC
 
Yes
 
(20)VALLEYCARE MEDICAL FOUNDATION INC
1111 E STANLEY BLVD

LIVERMORE,CA94550
26-2593526
SR. FACILITY CA 501(C)(3) PF SHC-TV
 
Yes
 
(21)VALLEYCARE SENIOR HOUSING
1111 E STANLEY BLVD

LIVERMORE,CA94550
94-3382224
SR. FACILITY CA 501(C)(3) 12A, I SHC-TV
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2023
Schedule R (Form 990) 2023
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



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

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




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



(k)
Percentage
ownership


Yes No Yes No
(1) ADOM PARTNERS LP

3 COLUMBUS CIRCLE 15TH FL
NEW YORK,NY10019
81-3083288
INVESTMENTS DE NA
 
                 
(2) ALBUS SELECT FUND LP

750 MENLO PARK AVE 380
MENLO PARK,CA94025
81-2064357
INVESTMENTS DE NA
 
                 
(3) AM ENGINE HOLDINGS FUND I LP

9450 SE GEMINI DRIVE PMB 17194
BEAVERTON,OR97008
92-3370261
INVESTMENTS DE NA
 
                 
(4) ARCOLA VENTURE LLC

7121 FAIRWAY DRIVE 410
PALM BEACH GARDENS,FL33418
37-1689632
REAL ESTATE DE NA
 
                 
(5) CANARY SC FUND LP

65 E 55TH ST 35TH FLOOR
NEW YORK,NY10022
47-5662144
INVESTMENTS DE NA
 
                 
(6) CANARY SC MASTER FUND LP

89 NEXUS WAY CAMANA BAY
GRAND CAYMAN,CAYMAN ISLANDSKY1-9009
CJ
98-1267847
INVESTMENTS CJ NA
 
                 
(7) CARLSBAD CO-INVEST LP

40 BEECHWOOD RD
SUMMIT,NJ07901
47-1702425
INVESTMENTS DE NA
 
                 
(8) CERASUS FUND II CAYMAN LP

190 ELGIN AVENUE GEORGE TOWN
GRAND CAYMAN   KY1-9008
CJ
INVESTMENTS CJ NA
 
                 
(9) CHP GTS BLOCKER HOLDINGS A LP

888 BOYLSTON STREET 1410
BOSTON,MA02199
83-0881152
INVESTMENTS DE NA
 
                 
(10) CROSSPOINT CAPITAL FUND II LP

2500 SAND HILL ROAD SUITE 300
MENLO PARK,CA94025
98-1656208
INVESTMENTS CA NA
 
                 
(11) CYPRESS MARINA HEIGHTS LLC

635 KNIGHT WAY
STANFORD,CA94305
95-4887979
INVESTMENTS CA NA
 
                 
(12) DGD INVESTMENT LP

190 ELGIN AVENUE GEORGE TOWN
GRAND CAYMAN   KY1-9008
CJ
INVESTMENTS CJ NA
 
                 
(13) EAGLE ROCK LI HOLDINGS LLC

1670 OLD COUNTRY RD 227
PLAINVIEW,NY11803
27-1694413
INVESTMENTS DE NA
 
                 
(14) EDEN RADIATION THERAPY SERVICES LLC

300 PASTEUR DRIVE
STANFORD,CA94304
88-1276056
HEALTHCARE CA NA
 
                 
(15) ER-S JV LLC

1670 OLD COUNTRY RD 227
PLAINVIEW,NY11803
83-4068077
INVESTMENTS DE NA
 
                 
(16) ER-S JV II LLC

1670 OLD COUNTRY RD 227
PLAINVIEW,NY11803
88-2085249
INVESTMENTS DE NA
 
                 
(17) ER-S INVESTOR LLC

1670 OLD COUNTRY RD 227
PLAINVIEW,NY11803
83-4068357
INVESTMENTS DE NA
 
                 
(18) ER-S INVESTOR II LLC

1670 OLD COUNTRY RD 227
PLAINVIEW,NY11803
88-2004082
INVESTMENTS DE NA
 
                 
(19) ER PROPERTIES FUND LLC

1670 OLD COUNTRY RD 227
PLAINVIEW,NY11803
83-4260396
INVESTMENTS DE NA
 
                 
(20) ER PROPERTIES FUND II LLC

1670 OLD COUNTRY RD 227
PLAINVIEW,NY11803
88-1994509
INVESTMENTS DE NA
 
                 
(21) EZP OPPORTUNITY LP

PIER 5 STE 102
SAN FRANCISCO,CA94111
81-4562962
INVESTMENTS DE NA
 
                 
(22) FORTRESS IW COINVESTMENT (FUND B) LP

1345 AVE OF THE AMERICAS 46FL
NEW YORK,NY10105
98-0509639
INVESTMENTS CJ NA
 
                 
(23) FOUR CROSSINGS INSTITUTIONAL PARTNERS V

ONE MARITIME PLAZA 2100
SAN FRANCISCO,CA94111
81-4323705
INVESTMENTS DE NA
 
                 
(24) FOXLANE LP

550 E WATER ST 888
CHARLOTTESVILLE,VA22902
81-3314647
INVESTMENTS DE NA
 
                 
(25) HHBG-II INVESTMENT LP

89 NEXUS WAY CAMANA BAY PO BOX 31
GRAND CAYMAN   KY1-1205
CJ
INVESTMENTS CJ NA
 
                 
(26) KEB INVESTORS II LP

WASHINGTON MALL STE 304 7 REID ST
HAMILTON,BDHM 11
BD
INVESTMENTS BD NA
 
                 
(27) KF VERMILLION FUND LP (AKA KEYFRAME V

65 East 55TH STREET 35TH FLOOR
NEW YORK,NY10022
88-3144517
INVESTMENTS DE NA
 
                 
(28) LSF V DHB HOLDINGS LP

2711 N HASKELL AVE 1700
DALLAS,TX75204
27-2858604
INVESTMENTS DE NA
 
                 
(29) OLIFANT FUND LTD

SUITE 5B201 2ND FL ONE NEXUS WAY
GRAND CAYMAN   KY1-1108
CJ
98-0404442
INVESTMENTS CJ NA
 
                 
(30) ONCOLOGY SOLUTIONS VENTURE LLC

300 PASTEUR DRIVE
STANFORD,CA94304
86-3250041
HEALTHCARE CA NA
 
                 
(31) OUTLAWS CASINO LTD

415 BROADWAY
REDWOOD CITY,CA94063
84-1457498
HOLDING COMPANY CO NA
 
                 
(32) SANDPIPER FUND LP

4215 WEST LOVERS LANE SUITE 1000
DALLAS,TX75209
26-0341626
INVESTMENT TX NA
 
                 
(33) SCP REAL ASSETS FUND (A) LP

2498 SAND HILL RD
MENLO PARK,CA94025
20-3949682
INVESTMENTS DE NA
 
                 
(34) SEQUOIA MFM OPERATING COMPANY LLC

770 WELCH ROAD LPCH
PALO ALTO,CA94304
47-5060529
MFM PROGRAM CA NA
 
                 
(35) SP SMC PARTNERS LLC

PO BOX 5377
NEW YORK,NY10185
47-3103791
INVESTMENTS DE NA
 
                 
(36) STANFORD EMANUEL RADIATION ONCOLOGY CENT

825 DELBON AV
TURLOCK,CA95382
20-8885091
RADIOLOGY CA NA
 
                 
(37) STANFORD PET-CT LLC

300 PASTEUR DR
STANFORD,CA94305
61-1423414
MED. DIAGNOST CA NA
 
                 
(38) STANFORD-STARTX FUND LLC

485 BROADWAY
REDWOOD CITY,CA94063
46-4297719
INVESTMENTS DE NA
 
                 
(39) SUMIT HOLDING INTERNATIONAL LLC

1400 PAGE MILL RD
PALO ALTO,CA94304
26-3934706
HOLDING COMPANY DE NA
 
                 
(40) TESSERA IONIC LP

PO BOX 194170
SAN FRANCISCO,CA941194170
83-0896257
INVESTMENTS DE NA
 
                 
(41) VEDA INVESTORS FUND LP

ONE FAWCETT PL
GREENWICH,CT06830
81-1810345
INVESTMENTS DE NA
 
                 
(42) VERMILION PEAK MASTER FUND

PO BOX 309 UGLAND HOUSE
GRAND CAYMAN   KY1-1104
CJ
98-1327671
INVESTMENTS CJ NA
 
                 
(43) WREP III A LP

6710 E CAMELBACK RD 100
SCOTTSDALE,AZ85251
47-4780701
INVESTMENTS DE NA
 
                 
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) BREP VII ALBERTA FDR (OFFSHORE) TE7 LP

345 PARK AVENUE
NEW YORK,NY10154
98-1066351
INVESTMENTS CA NA
 
C CORP          
(2) BREP VII ALBERTA FDR (OFFSHORE) TE7-NQ

345 PARK AVENUE
NEW YORK,NY10154
98-1066355
INVESTMENTS CA NA
 
C CORP          
(3) CANARY SC FUND LTD

89 NEXUS WAY CAYMANA BAY
GRAND CAYMAN   KY1-9009
CJ
92-1268195
INVESTMENTS CJ NA
 
C CORP          
(4) CLAT (13)

 
 
CHARITABLE TR CA NA
 
TRUST          
(5) CLUT (2)

 
 
CHARITABLE TR CA NA
 
TRUST          
(6) CRT (560)

 
 
CHARITABLE TR CA NA
 
TRUST          
(7) EAST SAIL

C/O INTL FS INC IFS COURT
TWENTYEIGHT CYBERCITY EBENE    
MP
INVESTMENTS MP NA
 
C CORP          
(8) ER-S REIT LLC

1670 OLD COUNTRY RD 227
PLAINVIEW,NY11803
83-4068725
INVESTMENTS DE NA
 
C CORP          
(9) ER-S REIT II LLC

1670 OLD COUNTRY RD 227
PLAINVIEW,NY11803
88-2004082
INVESTMENTS DE NA
 
C CORP          
(10) GAVEA INVESTMENT FUND II-C LP

PO BOX 309 UGLAND HOUSE
GRAND CAYMAN   KY1-1104
CJ
98-0537952
INVESTMENTS CJ NA
 
C CORP          
(11) HHBG SF LIMITED

89 NEXUS WAY CAMANA BAY
GRAND CAYMAN   KY1-1205
CJ
INVESTMENTS CJ NA
 
C CORP          
(12) KAIZEN FUND

PO BOX 448
GRAND CAYMAN   KY1-1106
CJ
INVESTMENTS CJ NA
 
C CORP          
(13) LS ALBERTA III LP

C/O LASALLE INV MGMT ONE CURZON ST
LONDON   W1J 5HD
UK
INVESTMENTS CA NA
 
C CORP          
(14) LUMINA STRATEGIC SOLUTIONS FEEDER FUND (

199 BAY STREET SUITE 5300
TORONTO   M5L 1B9
CA
98-1662307
INVESTMENTS CA NA
 
C CORP          
(15) OTHER (3)

 
 
CHARITABLE TR CA NA
 
TRUST          
(16) PIF (2)

 
 
CHARITABLE TR CA NA
 
TRUST          
(17) PEPPERTREE CAPITAL CAYMAN ISLAND FUND LP

57 E WASHINGTON STREET
CHAGRIN FALLS,OH44022
98-1235268
INVESTMENTS CJ NA
 
C CORP          
(18) PROFESSIONAL EXCHANGE ASSURANCE COMPANY

201 MERCHANT STREET SUITE 2400
HONOLULU,HI96813
90-0897686
INSURANCE HI NA
 
C CORP          
(19) SBFF LTD

SUITE 5B201 2ND FL ONE NEXUS WAY
GRAND CAYMAN   KY1-1108
CJ
INVESTMENTS CJ NA
 
C CORP          
(20) SOLKATT LIMITED

190 ELGIN AVENUE GEORGE TOWN
GRAND CAYMAN   KY1-9008
CJ
INVESTMENTS CJ NA
 
C CORP          
(21) STANFORD (BEIJING) CNSLTNG CO LTD (WFOE)

5275TH FLBLDG CACADEMY SOUTH RD
BEIJING    
CH
EDUCATION CH NA
 
C CORP          
(22) STANFORD IN JAPAN GODO KAISHA

DOSHISHA UNIVERSITY MEITOKUKAN-NAI
KYOTOSHI    
JA
EDUCATION JA NA
 
C CORP          
(23) STANFORD INDIA PVT LTD

333 3RD FLOOR DEVIKA TOWER 6 NEH
DELHI    
IN
EDUCATION IN NA
 
C CORP          
(24) STANFORD MEDICINE INTL (HONG KONG) CO LT

833 CHEUNG SHA WAN ROAD
KOWLOON    
HK
PATIENT SRVC HK NA
 
C CORP          
(25) STANFORD UNIV MED NETWORK RISK AUTHORITY

1400 PAGE MILL RD MSC 5713
PALO ALTO,CA94304
46-1132002
RISK MGMT CON CA NA
 
C CORP          
(26) TF-A FEEDER LTD

89 NEXUS WAY CAMANA BAY
GRAND CAYMAN   KY1-1205
CJ
98-1756669
INVESTMENTS CJ NA
 
C CORP          
(27) THE RUBRUM FUND

7 CLIFFORD STREET
LONDON   WIS 2FT
UK
INVESTMENTS CJ NA
 
C CORP          
(28) TRIVISTA FUND

89 NEXUS WAY CAMANA BAY
GRAND CAYMAN   KY1-9009
CJ
INVESTMENTS CJ NA
 
C CORP          
(29) TVC MATSU FUND

89 NEXUS WAY CAMANA BAY
GRAND CAYMAN   KY1-9009
CJ
INVESTMENTS CJ NA
 
C CORP          
(30) VERMILION PEAK FUND

PO BOX 309 UGLAND HOUSE
GRAND CAYMAN   KY1-1104
CJ
98-1333885
INVESTMENTS CJ NA
 
C CORP          
(31) WOODBOURNE CANADA PARTNERS II - CAYMAN

190 ELGIN AVE
GRAND CAYMAN   KY1-9005
CJ
98-0705321
INVESTMENTS CJ NA
 
C CORP          
Schedule R (Form 990) 2023
Schedule R (Form 990) 2023
Page 3
Part V
Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
 
No
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
 
No
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved





Schedule R (Form 990) 2023
Schedule R (Form 990) 2023
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

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




(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2023
Schedule R (Form 990) 2023
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. See instructions.
Return Reference Explanation
SCHEDULE R, PART III, COLUMNS (E), (F), (G), (H), (I), (J), AND (K) RESPONSE IS "N/A" FOR ALL ORGANIZATIONS.
SCHEDULE R, PART IV CHARITABLE LEAD ANNUITY TRUSTS ARE PRINCIPALLY DOMICILED IN CALIFORNIA. CHARITABLE LEAD UNITRUSTS ARE PRINCIPALLY DOMICILED IN CALIFORNIA. CHARITABLE REMAINDER TRUSTS ARE PRINCIPALLY DOMICILED IN CALIFORNIA OTHER TRUSTS ARE PRINCIPALLY DOMICILED IN CALIFORNIA POOLED INCOME FUNDS ARE PRINCIPALLY DOMICILED IN CALIFORNIA.
SCHEDULE R, PART IV, COLUMNS (F), (G), AND (H) RESPONSE IS "N/A" FOR ALL ORGANIZATIONS.
Schedule R (Form 990) 2023

Additional Data


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