2023-11-15T13:25:19-06:00 2022-12-31 951777440 GREEN HASSON & JANKS LLP 700 SOUTH FLOWER STREET SUITE 3300 LOS ANGELES CA 90017 990 2022-01-01 956100079 SAINT JOHN'S HEALTH CENTER FOUNDATION SAIN 3108298424 2121 SANTA MONICA BOULEVARD SANTA MONICA CA 90404 STELLA NICHOLS CFO/COO 3108298424 2023-11-14 1 STELLA NICHOLS 999009999 1 LIZBETH G NEVAREZ P01399868 3108731600 2023-11-14 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z STELLA NICHOLS 2121 SANTA MONICA BOULEVARD SANTA MONICA CA 90404 59965727 0 X HTTPS://SAINTJOHNSFOUNDATION.ORG X 1948 CA TO PROVIDE LEADERSHIP AND PHILANTHROPIC SUPPORT TO PROVIDENCE SAINT JOHN'S HEALTH CENTER, SAINT JOHN'S CANCER INSTITUTE (FORMERLY JOHN WAYNE CANCER INSTITUTE), AND PACIFIC NEUROSCIENCE INSTITUTE FOUNDATION, THAT SERVE AS CATALYSTS FOR EXCEPTIONAL HEALTH CARE AND RESEARCH. THROUGH THE AFFILIATION ENDOWMENT, PROVIDE DIRECT HEALTH CARE SERVICES INCLUDING WELLNESS PROGRAMS, HEALTH RESEARCH AND EDUCATION TO THE RESIDENTS IN PROVIDENCE SAINT JOHN'S HEALTH CENTER SERVICE AREA (29 ZIP CODES). 124 123 34 230 0 45523 56225795 35879255 0 0 13274551 2868339 117150 117150 69617496 38864744 29076622 32364605 0 0 6395270 6933405 0 0 6946930 1528227 2552128 37000119 41850138 32617377 -2985394 350839602 326428369 8509505 14061831 342330097 312366538 X TO PROVIDE LEADERSHIP AND PHILANTHROPIC SUPPORT TO PROVIDENCE SAINT JOHN'S HEALTH CENTER, JOHN WAYNE CANCER INSTITUTE (RENAMED TO SAINT JOHN'S CANCER INSTITUTE SUBSEQUENT TO YEAR END MAY 2021), AND PACIFIC NEUROSCIENCE INSTITUTE FOUNDATION, THAT SERVE AS CATALYSTS FOR EXCEPTIONAL HEALTH CARE AND RESEARCH. THROUGH THE AFFILIATION ENDOWMENT, PROVIDE DIRECT HEALTH CARE SERVICES INCLUDING WELLNESS PROGRAMS, HEALTH RESEARCH AND EDUCATION TO THE RESIDENTS IN PROVIDENCE SAINT JOHN'S HEALTH CENTER SERVICE AREA (29 ZIP CODES). 0 0 16292762 16292762 TO SUPPORT VARIOUS PROGRAMS AND SERVICES BENEFITTING THE HEART, ORTHO, NURSING AND OTHER VARIOUS DEPARTMENTS OF THE PROVIDENCE SAINT JOHN'S HEALTH CENTER. 9242636 9242636 TO SUPPORT THE ONGOING BRAIN HEALTH RESEARCH STUDIES AND ADVANCEMENT OF TREATMENT MODALITIES AT PACIFIC NEUROSCIENCE INSTITUTE FOUNDATION. 5259273 5259273 TO SUPPORT THE ONGOING RESEARCH STUDIES AND TREATMENT MODALITIES AT SAINT JOHN'S CANCER INSTITUTE 1400000 1400000 AFFILIATION ENDOWMENT TO SUPPORT NONPROFIT TAX-EXEMPT CHARITABLE HEALTHCARE FACILITIES AND CLINICS, INCLUDING, BUT NOT LIMITED TO, GENERAL ACUTE CARE HOSPITALS, IN PROVIDING DIRECT HEALTH CARE SERVICES AND ACCESS THERETO, INCLUDING WELLNESS PROGRAMS, HEALTH RESEARCH AND HEALTH EDUCATION TO IMPROVE HEALTH TO THE RESIDENTS IN PROVIDENCE SAINT JOHN'S HEALTH CENTER'S SERVICE AREA (29 ZIP CODES). 169934 169934 TO SUPPORT THE ONGOING EFFORTS OF SAINT JOHN'S PHYSICIAN PARTNERS, A NETWORK OF PRIMARY CARE AND SPECIALTY CARE PHYSICIANS SERVING THE WESTSIDE LOS ANGELES COMMUNITIES AND BEYOND, IN MAKING ITS SERVICES KNOWN TO PATIENTS THROUGH DEVELOPMENT OF A ROBUST AND INFORMATIVE WEBSITE. 1569934 1569934 32364605 1 1 0 0 0 0 0 0 0 1 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 1 0 0 1 34 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 X 124 123 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X STELLA NICHOLS 3108298424 2221 SANTA MONICA BLVD SANTA MONICA CA 90404 ROBERT O KLEIN PRESIDENT & CEO 40.00 0.00 X X 717866 0 77861 STELLA NICHOLS CFO & COO 40.00 0.00 X 455370 0 49023 MICHAEL D AVILA SVP, DEVELOPMENT 40.00 0.00 X 356195 0 26780 ANDREW C TRILLING VP, PLANNED & PRINCIPAL GIFTS 40.00 0.00 X 267586 0 39352 MELISSA THRASHER EXECUTIVE DIRECTOR MARKETING 40.00 0.00 X 237113 0 13279 ESTHER COOKIE GALANTI SR DIRECTOR PHILANTHROPY 40.00 0.00 X 220441 0 27195 JEANNE GOLDSMITH EXECUTIVE DIRECTOR MAJOR GIFTS 40.00 0.00 X 203739 0 24123 ROGER WACKER CHAIR 5.00 0.00 X 0 0 0 ROBERT S AMONIC MD SECRETARY 2.00 0.00 X 0 0 0 CRAIG C BENELL TREASURER 2.00 0.00 X 0 0 0 CHARLES F ADAMS TRUSTEE 1.00 0.00 X 0 0 0 WILLIAM S ANDERSON TRUSTEE 1.00 0.00 X 0 0 0 WILLIAM M APFELBAUM TRUSTEE 1.00 0.00 X 0 0 0 RAE W ARCHIBALD TRUSTEE 2.00 0.00 X 0 0 0 MARGOT S ARMBRUSTER TRUSTEE 1.00 0.00 X 0 0 0 J J ASSAF TRUSTEE 1.00 0.00 X 0 0 0 LEE A AULT TRUSTEE 1.00 0.00 X 0 0 0 DONNALISA P BARNUM TRUSTEE 1.00 0.00 X 0 0 0 KATHY K BARRETT TRUSTEE 1.00 0.00 X 0 0 0 FRANK E BAXTER TRUSTEE 1.00 0.00 X 0 0 0 RUDOLPH A BEDFORD MD TRUSTEE 1.00 0.00 X 0 0 0 JAMES P BIRDWELL TRUSTEE 2.00 0.00 X 0 0 0 NORRIS J BISHTON TRUSTEE 1.00 0.00 X 0 0 0 ERIC K BORSTEIN TRUSTEE 1.00 0.00 X 0 0 0 JOHN C BOWLIN TRUSTEE 1.00 0.00 X 0 0 0 ABBOTT L BROWN TRUSTEE 1.00 0.00 X 0 0 0 JULES BUENABENTA TRUSTEE 1.00 0.00 X 0 0 0 CHARLES G CALE TRUSTEE 1.00 0.00 X 0 0 0 RICK J CARUSO TRUSTEE 1.00 0.00 X 0 0 0 ALEX M CHAVES TRUSTEE 1.00 0.00 X 0 0 0 SCOTT M COHEN TRUSTEE 1.00 0.00 X 0 0 0 JONATHAN R COLE TRUSTEE 1.00 0.00 X 0 0 0 JONATHAN L CONGDON TRUSTEE 1.00 0.00 X 0 0 0 CYNTHIA S CONNOLLY TRUSTEE 1.00 0.00 X 0 0 0 RICHARD F CORLIN MD TRUSTEE 1.00 0.00 X 0 0 0 ANGELA COURTIN TRUSTEE 1.00 0.00 X 0 0 0 MARIAN H CRAVER TRUSTEE 1.00 0.00 X 0 0 0 MICHAEL W CROFT TRUSTEE 1.00 0.00 X 0 0 0 RICHARD R CROWELL TRUSTEE 1.00 0.00 X 0 0 0 KATHY A DANHAKL TRUSTEE 1.00 0.00 X 0 0 0 MARY Y DAVIS TRUSTEE - TERM ENDED DEC 2022 1.00 0.00 X 0 0 0 GEORGE H DAVIS TRUSTEE 1.00 0.00 X 0 0 0 KEVIN M EHRHART MD TRUSTEE 1.00 0.00 X 0 0 0 MARC EZRALOW TRUSTEE 1.00 0.00 X 0 0 0 MILES FISHER TRUSTEE 1.00 0.00 X 0 0 0 MARY M FLAHERTY TRUSTEE 1.00 0.00 X 0 0 0 FRANCES R FLANAGAN TRUSTEE 1.00 0.00 X 0 0 0 JAMES H FORDYCE TRUSTEE - TERM ENDED DEC 2022 1.00 0.00 X 0 0 0 BRADFORD M FREEMAN TRUSTEE 1.00 0.00 X 0 0 0 WILLIAM M GARLAND III TRUSTEE 1.00 0.00 X 0 0 0 RISA L GERTNER TRUSTEE 1.00 0.00 X 0 0 0 KRISTIN GIBELLO TRUSTEE 1.00 0.00 X 0 0 0 JOHN F GOEDERS TRUSTEE 1.00 0.00 X 0 0 0 ALLAN B GOLDMAN TRUSTEE 1.00 0.00 X 0 0 0 JAE GOODMAN TRUSTEE 1.00 0.00 X 0 0 0 GLENN A GORLITSKY MD TRUSTEE 1.00 0.00 X 0 0 0 ARSALAN GOZINI TRUSTEE 1.00 0.00 X 0 0 0 ELIZABETH GREGORY RIORDAN TRUSTEE 1.00 0.00 X 0 0 0 THOMAS F GROJEAN TRUSTEE - TERM ENDED DEC 2022 1.00 0.00 X 0 0 0 MICHAEL D HACKMAN TRUSTEE 1.00 0.00 X 0 0 0 PETER V HAIGHT TRUSTEE 1.00 0.00 X 0 0 0 DAVID L HO TRUSTEE 1.00 0.00 X 0 0 0 MARCIA W HOBBS TRUSTEE - 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TERM ENDED DEC 2022 1.00 0.00 X 0 0 0 PETER C PELIKAN MD TRUSTEE 1.00 0.00 X 0 0 0 MARY PATRICIA PENCE TRUSTEE 1.00 0.00 X 0 0 0 JILL E POSNICK TRUSTEE - TERM ENDED APR 2022 1.00 0.00 X 0 0 0 DALLAS P PRICE-VAN BREDA TRUSTEE 1.00 0.00 X 0 0 0 ERNIE L PRUDENTE MD TRUSTEE 1.00 0.00 X 0 0 0 JUSTIN E RAWLINS TRUSTEE 1.00 0.00 X 0 0 0 ERIC G REITER TRUSTEE 1.00 0.00 X 0 0 0 MICHAEL R RICKS TRUSTEE 1.00 0.00 X 0 0 0 JOHN M ROBERTSON MD TRUSTEE 1.00 0.00 X 0 0 0 JEANNE ROBINSON TRUSTEE 1.00 0.00 X 0 0 0 VICTORIA ROGERS TRUSTEE 1.00 0.00 X 0 0 0 THEODORE H SCHNEIDER TRUSTEE 1.00 0.00 X 0 0 0 CAROLE B SCHWARTZ TRUSTEE 1.00 0.00 X 0 0 0 DONNA L SCHWEERS TRUSTEE 1.00 0.00 X 0 0 0 ROBERT SHUWARGER TRUSTEE 1.00 0.00 X 0 0 0 LAURA SIART TRUSTEE 2.00 0.00 X 0 0 0 WILLIAM E SIMON JR TRUSTEE 1.00 0.00 X 0 0 0 CAROLYN L SINGLETON TRUSTEE 1.00 0.00 X 0 0 0 ROSA SINNOTT TRUSTEE 1.00 0.00 X 0 0 0 LORAINE B SINSKEY TRUSTEE 1.00 0.00 X 0 0 0 MICHAEL S SITRICK TRUSTEE 1.00 0.00 X 0 0 0 CHARLES F SMITH TRUSTEE 1.00 0.00 X 0 0 0 BRENT STRATTON TRUSTEE - TERM ENDED DEC 2022 1.00 0.00 X 0 0 0 JUAN SUAREZ TRUSTEE 1.00 0.00 X 0 0 0 NADINE E TILLEY TRUSTEE 1.00 0.00 X 0 0 0 JAMES J TOTH TRUSTEE 1.00 0.00 X 0 0 0 JOHN D TRACY TRUSTEE 1.00 0.00 X 0 0 0 DONNA C TUTTLE TRUSTEE 1.00 0.00 X 0 0 0 BENNET M VAN DE BUNT TRUSTEE 1.00 0.00 X 0 0 0 PATRICK J WAYNE TRUSTEE - TERM ENDED DEC 2022 1.00 0.00 X 0 0 0 BRIAN M WEBBER TRUSTEE 1.00 0.00 X 0 0 0 STEPHANIE C WESTON TRUSTEE 1.00 0.00 X 0 0 0 EDWARD L WHITE TRUSTEE 1.00 0.00 X 0 0 0 SHANNON M WICKSTROM TRUSTEE 1.00 0.00 X 0 0 0 GRETCHEN A WILLISON TRUSTEE 1.00 0.00 X 0 0 0 MICHAEL E WISE TRUSTEE 1.00 0.00 X 0 0 0 BRETT G WYARD TRUSTEE 1.00 0.00 X 0 0 0 2458310 0 257613 18 0 1 0 KORN FERRY (US) 1900 AVENUE OF THE STARS SUITE 260 LOS ANGELES CA 90067 EXECUTIVE SEARCH 177408 JJLA LLC 3780 WILSHIRE BLVD SUITE 601 LOS ANGELES CA 90403 EVENT PRODUCTION 142616 MOON TIDE AGENCY LLC 200 N SEPULVEDA BLVD SUITE 110 EL SEGUNDO CA 90245 MAGAZINE PRINTING SERVICE 103310 3 35879255 2134466 35879255 2267787 2267787 117150 0 117150 117150 117150 21701535 21100983 600552 600552 600552 38864744 0 0 2985489 32364605 32364605 1256929 252576 1004353 4057478 815338 3242140 129019 25926 103093 1489979 299407 1190572 200400 97158 103242 68400 68400 70307 70307 479316 195798 283518 712047 306073 405974 177152 174608 2544 67920 66944 976 EVENTS EXPENSE 554442 128412 426030 EQUIPMENT RENTAL 113052 26184 86868 DONOR RECOGNITION 77572 6605 70967 PROSPECT RESEARCH 31520 4867 26653 41850138 32364605 2538603 6946930 137610998 80293960 54172441 31356552 7752333 406801 6097502 7345532 13072234 74766792 132076722 120993937 7809705 11671596 350839602 326428369 8509505 14061831 8509505 14061831 X 119520227 118665248 222809870 193701290 342330097 312366538 350839602 326428369 X -2985394 -26197294 -780871 X X 0 1 X 1 0 X 38633786 77310438 87609073 56225795 35879255 295658347 38633786 77310438 87609073 56225795 35879255 295658347 60387331 235271016 1852950 2141342 1692717 173156 2384937 8245102 117153 117153 304020602 0.77390 0.75690 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 32741593 1033610 -2058529 598860 31117814 28050825 3850001 1566219 725452 32741593 26389403 162398 2276673 777649 28050825 25003770 269880 2006376 890623 26389403 25532695 900200 -742544 686581 25003770 0.14660 0.73373 0.11967 0 0 860000 5282462 6142462 455950 1153921 406801 1203070 7345532 120993937 F 120993937 OBLIGATIONS UNDER CHARITABLE GIFT ANNUITIES 2186186 DUE TO SAINT JOHN'S HEALTH CENTER & INSTITUTES 10792109 DUE TO SAINT JOHN'S HEALTH CENTER (OPERATING EXPENSES) 752089 MISCELLANEOUS LIABILITIES 331447 14061831 X 11816272 -26197294 -780871 -26978165 38794437 70307 70307 38864744 41779831 0 41779831 70307 70307 41850138 PART V, LINE 4: ENDOWMENT FUNDS ARE ESTABLISHED BY DONOR-RESTRICTED GIFTS AND BEQUESTS TO EITHER PROVIDE A PERMANENT ENDOWMENT, WHICH IS TO PROVIDE A PERMANENT SOURCE OF INCOME TO THE FOUNDATION, OR A TERM ENDOWMENT, WHICH IS TO PROVIDE INCOME FOR A SPECIFIED PERIOD TO THE FOUNDATION. PART X, LINE 2: THE FOUNDATION RECOGNIZES THE IMPACT OF TAX POSITIONS IN THE FINANCIAL STATEMENTS IF THAT POSITION IS MORE LIKELY THAN NOT TO BE SUSTAINED ON AUDIT, BASED ON THE TECHNICAL MERITS OF THE POSITION. DURING THE YEAR ENDED DECEMBER 31, 2022, THE FOUNDATION PERFORMED AN EVALUATION OF UNCERTAIN TAX POSITIONS AND DID NOT NOTE ANY MATTERS THAT WOULD REQUIRE RECOGNITION IN THE FINANCIAL STATEMENTS OR WHICH MIGHT HAVE AN EFFECT ON ITS TAX-EXEMPT STATUS. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE OF GIFT ANNUITIES RECEIVABLE -319,008. CHANGE IN VALUE OF BENEFICIAL INTEREST IN CHARITABLE REMAINDER TRUSTS -461,863. 1 PROVIDENCE SAINT JOHN'S HEALTH CENTER 2121 SANTA MONICA BLVD SANTA MONICA CA 90404 951684082 501(C)3 16292762 0 VARIOUS PROGRAMS AND SERVICES PACIFIC NEUROSCIENCE INSTITUTE FOUNDATION 2125 ARIZONA BLVD SANTA MONICA CA 90404 475552178 501(C)3 9242636 0 RESEARCH SAINT JOHN'S CANCER INSTITUTE (FORMERLY JOHN WAYNE CANCER INSTITUTE) 2200 SANTA MONICA BLVD SANTA MONICA CA 90404 954291515 501(C)3 5259273 0 RESEARCH SAINT JOHN'S CANCER INSTITUTE (FORMERLY JOHN WAYNE CANCER INSTITUTE) 2121 SANTA MONICA BLVD SANTA MONICA CA 90404 954291515 501(C)3 175000 0 SURGICAL ONCOLOGY FELLOWSHIP PROGRAM SAINT JOHN'S PHYSICIAN PARTNERS 20555 EARL STREET TORRANCE CA 90503 814542216 501(C)3 169934 0 WEBSITE DEVELOPMENT PROVIDENCE SAINT JOHN'S HEALTH CENTER COMMUNITY BENEFIT PROGRAMS 2121 SANTA MONICA BLVD SANTA MONICA CA 90404 951684082 501(C)3 127000 0 HOMELESS CARE NAVIGATION PROGRAM PROVIDENCE SAINT JOHN'S HEALTH CENTER CLEFT PALATE CENTER 2121 SANTA MONICA BLVD SANTA MONICA CA 90404 951684082 501(C)3 120000 0 CLEFT PALATE CENTER SPEECH SCHOLARSHIPS PROVIDENCE SAINT JOHN'S HEALTH CENTER CHILD AND FAMILY DEVELOPMENT CENTER 2121 SANTA MONICA BLVD SANTA MONICA CA 90404 951684082 501(C)3 100000 0 PERINATAL WELLNESS PROGRAM WESTSIDE FOOD BANK 1710 22ND STREET SANTA MONICA CA 90404 953685875 501(C)3 75000 0 FOOD PURCHASES UCLA VA FAMILY RESOURCE AND WELL-BEING CENTER 10889 WILSHIRE BLVD SUITE 700 LOS ANGELES CA 90024 952250801 501(C)3 65000 0 SUPPORTING TRANSITION TO HOUSING FOR VETERANS SAFE PARKING LA 961 S MARIPOSA AVE LOS ANGELES CA 90006 954302067 501(C)3 60000 0 HOUSING STABILIZATION AND RETENTION CATHOLIC CHARITIES OF LOS ANGELES INC 1531 JAMES M WOOD BLVD LOS ANGELES CA 90015 951690973 501(C)3 50000 0 THE LANDING AT ST. ROBERT'S CENTER THE PEOPLE CONCERN 2116 ARLINGTON AVENUE SUITE 100 LOS ANGELES CA 90018 956143865 501(C)3 50000 0 WESTSIDE INTERIM HOUSING AND WELLNESS PROGRAM THE PEOPLE CONCERN SOJOURN DOMESTIC VIOLENCE PROGRAM 2116 ARLINGTON AVENUE SUITE 100 LOS ANGELES CA 90018 367367351 501(C)3 50000 0 SERVICES FOR BATTERED WOMEN AND THEIR CHILDREN US VETS 800 W SIXTH STREET SUITE 1505 LOS ANGELES CA 90017 954382752 501(C)3 50000 0 OUTREACH SERVICES FOR HOMELESS AND AT-RISK VETS IN WEST LA VISION TO LEARN 12100 WILSHIRE BLVD SUITE 1275 LOS ANGELES CA 90025 453457853 501(C)3 50000 0 FREE SCREENINGS, EXAMS & GLASSES WISE AND HEALTHY AGING 1527 4TH STREET 2 SANTA MONICA CA 90401 952788014 501(C)3 50000 0 ADULT DAY CENTER SPANISH LANGUAGE AND LIVE ALONE EXPANSION SAFE PLACE FOR YOUTH 340 SUNSET AVENUE VENICE CA 90291 841802637 501(C)3 42000 0 HEALTH AND CLINICAL PROGRAMS SANTA MONICA EDUCATION FOUNDATION 1645 16TH STREET SANTA MONICA CA 90404 953787674 501(C)3 39000 0 STUDENT WELLNESS PROGRAMS PROVIDENCE SAINT JOHN'S PHYSICIAN PARTNERS 2020 SANTA MONICA BLVD SUITE 300 SANTA MONICA CA 90404 814542216 501(C)3 32000 0 HYPERTENSION INITIATIVE - FREE AT-HOME BLOOD PRESSURE MONITORS BOYS AND GIRLS CLUB OF SANTA MONICA 1220 LINCOLN BLVD SANTA MONICA CA 90401 951890706 501(C)3 30000 0 HEALTHY LIFESTYLES AND SOCIAL-EMOTIONAL HEALTH PROGRAM ST MONICA CATHOLIC SCHOOLS 1011 7TH STREET SANTA MONICA CA 90403 237071304 501(C)3 30000 0 HEALTH & WELLNESS PROGRAM CANCER SUPPORT COMMUNITY LA 1990 SOUTH BUNDY DRIVE SUITE 100 LOS ANGELES CA 90025 330287070 501(C)3 25000 0 CANCER CARE WITH PROVIDENCE SAINT JOHN'S HEALTH CENTER CLARIS HEALTH 11500 OLYMPIC BLVD STE 570 LOS ANGELES CA 90064 954806856 501(C)3 25000 0 FAMILY PRESERVATION & REUNIFICATION PROGRAM GROWING HOPE GARDENS 21145 COLINA DRIVE TOPANGA CA 90290 834524045 501(C)3 25000 0 FOOD GARDENS THAT EMPOWER MEALS ON WHEELS WEST 1823 MICHIGAN AVENUE SANTA MONICA CA 90404 954613280 501(C)3 25000 0 COMMUNITY CONNECTIONS OPICA 11759 MISSOURI AVENUE LOS ANGELES CA 90025 953493725 501(C)3 25000 0 SPIRIT BUILDERS SANTA MONICA FAMILY YMCA 1332 6TH STREET SANTA MONICA CA 90401 953691421 501(C)3 25000 0 BIG BEAR CAMP YOUTH SCHOLARSHIPS PACIFIC PALISADES-MALIBU YMCA 821 VIA DE LA PAZ PACIFIC PALISADES CA 90272 951644052 501(C)3 25000 0 TEEN IMPACT PROGRAM CATHOLIC BIG BROTHERS BIG SISTERS 1530 JAMES M WOOD BLVD 2ND FLOOR LOS ANGELES CA 90015 951904857 501(C)3 10000 0 WELLNESS MENTORING PROGRAM-NAVIGATIONAL SUPPORT ST JAMES INN PO BOX 64494 LOS ANGELES CA 90064 954573028 501(C)3 10000 0 TEMPORARY HOUSING FOR PATIENTS BANDINI FOUNDATION 5857 CAPE HORN DRIVE AGOURA HILLS CA 91301 452470468 501(C)3 10000 0 MISSION VETS 22 0 PART I, LINE 2: FUNDS TO PROVIDENCE SAINT JOHN'S HEALTH CENTER ARE GRANTED AFTER THE EXPENSES HAVE BEEN INCURRED AND SUPPORTED BY COPIES OF INVOICES PAID RELATED TO EACH GRANT. THE ENTITIES SAINT JOHN'S CANCER INSTITUTE, PACIFIC NEUROSCIENCE INSTITUTE FOUNDATION, AND SAINT JOHN'S PHYSICIAN PARTNERS PROVIDE THE SAINT JOHN'S HEALTH CENTER FOUNDATION WITH AN ITEMIZED BILL. SAINT JOHN'S HEALTH CENTER FOUNDATION TRANSFERS THE FUNDS TO EACH RELATED ENTITY THE SUBSEQUENT MONTH. AFFILIATION ENDOWMENT GRANTEES ARE REQUIRED TO SUBMIT REPORTS TO SAINT JOHN'S HEALTH CENTER FOUNDATION INDICATING HOW THE FUNDS WERE SPENT. X X X X X X 0 0 0 0 0 0 0 1 0 ROBERT O KLEIN PRESIDENT & CEO 549923 0 167943 0 0 0 64899 0 12962 0 795727 0 0 0 STELLA NICHOLS CFO & COO 357184 0 98186 0 0 0 39799 0 9224 0 504393 0 0 0 MICHAEL D AVILA SVP, DEVELOPMENT 311835 0 44360 0 0 0 17632 0 9148 0 382975 0 0 0 ANDREW C TRILLING VP, PLANNED & PRINCIPAL GIFTS 233001 0 34585 0 0 0 19660 0 19692 0 306938 0 0 0 MELISSA THRASHER EXECUTIVE DIRECTOR MARKETING 217113 0 20000 0 0 0 3378 0 9901 0 250392 0 0 0 ESTHER COOKIE GALANTI SR DIRECTOR PHILANTHROPY 199524 0 20917 0 0 0 17824 0 9371 0 247636 0 0 0 JEANNE GOLDSMITH EXECUTIVE DIRECTOR MAJOR GIFTS 179762 0 23977 0 0 0 14820 0 9303 0 227862 0 0 0 PART I, LINE 7 THE BOARD APPROVED THE BONUS FOR ROBERT O. KLEIN, STELLA NICHOLS, MICHAEL AVILA, ESTHER GALANTI, ANDREW TRILLING, MELISSA THRASHER, AND JEANNE GOLDSMITH. X 1 130000 APPRAISAL X 1 232 SELLING PRICE X 25 546497 FAIR MARKET VALUE X 1 100 BOND FACE VALUE X 1 1315950 COST APPROACH X 1 5010 SELLING PRICE X 2 2368 SELLING PRICE X 1 85499 CARRYING (BOOK) VALUE X ESTATE AUCTION ITEMS 1 17395 SELLING PRICE X EVENT GIVEAWAYS 5 17021 SELLING PRICE X PERSONAL PRODUCTS & JEWELRY 2 12894 SELLING PRICE X GIFT CARDS 2 1500 SELLING PRICE 1 0 1 1 PART I, COLUMN (B): NONCASH DONATIONS ARE LISTED BY TOTAL NUMBER OF DONORS. PART I, LINE 32B: CARS2CHARITIES FOR VEHICLE DONATIONS. ABELL AUCTION COMPANY: FOR TANGIBLE NON-CASH CONTRIBUTIONS (SUCH AS ARTWORK) THAT ARE NOT HELD IN INVENTORY (OTHER ASSETS). FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE IS A BOARD COMMITTEE AND SHALL HAVE AT LEAST FIVE (5) TRUSTEES AS MEMBERS, INCLUDING THE CHAIR, THE PRESIDENT, EITHER THE PROVIDENCE CEO OR THE PROVIDENCE COO, AND OTHER TRUSTEES APPOINTED BY THE BOARD. THE EXECUTIVE COMMITTEE SHALL ACT FOR THE FULL BOARD BETWEEN BOARD MEETINGS, EXCEPT THAT THE EXECUTIVE COMMITTEE SHALL NOT TAKE ANY ACTION SPECIFIED IN SECTION 2 OF ARTICLE V OR OUTSIDE THE ORDINARY COURSE OF BUSINESS OR SPECIFICALLY RESERVED TO THE FULL BOARD BY RESOLUTION. THE EXECUTIVE COMMITTEE SHALL BE RESPONSIBLE FOR THE PERIODIC EVALUATION OF THE PERFORMANCE AND COMPENSATION OF THE PRESIDENT & CEO. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS TWO MEMBERS, THE PROVIDENCE HEALTH SYSTEM SOUTHERN CALIFORNIA AND SAINT JOHN'S HEALTH CENTER FOUNDATION GOVERNANCE INC. WHO ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY. DECISIONS OF THE GOVERNING BODY ARE SUBJECT TO APPROVAL BY THE MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION HAS MEMBERS WHO ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF THE GOVERNING BODY ARE SUBJECT TO APPROVAL BY THE MEMBERS. FORM 990, PART VI, SECTION B, LINE 11B AN ELECTRONIC COPY OF THE 990 AND ITS SUPPORTING SCHEDULES WERE DISTRIBUTED TO THE SAINT JOHN'S HEALTH CENTER FOUNDATION (FOUNDATION) MANAGEMENT TEAM, AUDIT AND COMPLIANCE COMMITTEE AND EXECUTIVE COMMITTEE FOR THEIR REVIEW PRIOR TO FILING. THE FOUNDATION FORM 990 IS PREPARED AND REVIEWED BY AN INDEPENDENT AUDITING FIRM. FORM 990 IS MADE AVAILABLE TO TO THE FULL GOVERNING BODY UPON REQUEST. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST PROCESS IS MANAGED AND MONITORED BY PROVIDENCE RISK AND INTEGRITY SERVICES - COMPLIANCE. ANNUAL QUESTIONNAIRES ARE DISTRIBUTED AND "AFFECTED AND INTERESTED PERSONS" WHO VIOLATE THE POLICY ARE SUBJECT TO APPROPRIATE CORRECTIVE ACTION. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION USES THE FOLLOWING IN ESTABLISHING THE COMPENSATION OF OFFICERS INDEPENDENTLY, WITHOUT THE PARTICIPATION OF INTERESTED PERSONS: COMPENSATION COMMITTEE; INDEPENDENT COMPENSATION CONSULTANTS; COMPENSATION SURVEYS AND STUDIES; APPROVAL BY THE EXECUTIVE COMMITTEE. FORM 990, PART VI, SECTION B, LINE 15B: THE ORGANIZATION USES THE FOLLOWING IN ESTABLISHING THE COMPENSATION OF OTHER OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION INDEPENDENTLY, WITHOUT THE PARTICIPATION OF INTERESTED PERSONS: COMPENSATION SURVEYS AND STUDIES; COMP RATES THRU OUT PROVIDENCE SYSTEM. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF GIFT ANNUITIES RECEIVABLE -319,008. CHANGE IN VALUE OF BENEFICIAL INTEREST IN CHARITABLE REMAINDER TRUSTS -461,863. FORM 990, PART XII, LINE 2C: NO PROCESSES HAVE CHANGED FROM THE PRIOR YEAR. SAINT JOHN'S HEALTH CENTER FOUNDATION GOVERNANCE INC 2121 SANTA MONICA BLVD SANTA MONICA CA 90404 473249939 CORPORATE MEMBER CA 501(C)(4) N/A 0 PACIFIC NEUROSCIENCE INSTITUTE FOUNDATION 2125 ARIZONA AVENUE SANTA MONICA CA 90404 475552178 ADVANCE NEUROSCIENCE CLINICAL CARE CA 501(C)(3) LINE 7 N/A 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0