2015-11-05T16:28:07-06:00 2014-12-31 951777440 GREEN HASSON & JANKS LLP 10990 WILSHIRE BLVD 16TH FLOOR LOS ANGELES CA 900243929 990 2014-01-01 956100079 SAINT JOHN'S HOSPITAL HEALTH CENTER FOUNDATION SAIN 3108298424 2121 SANTA MONICA BOULEVARD SANTA MONICA CA 90404 STELLA NICHOLS CFO 3108298424 2015-10-20 1 RICHARD L RUVELSON P00234075 3108731600 2014 2016-04-25 22:37:26Z SAINT JOHN'S HEALTH CENTER FDN STELLA NICHOLS 2121 SANTA MONICA BOULEVARD SANTA MONICA CA 90404 20545475 0 X WWW.NEWSTJOHNS.ORG X 1948 CA TO PROVIDE LEADERSHIP AND PHILANTHROPIC SUPPORT TO PROVIDENCE SAINT JOHN'S HEALTH CENTER AND JOHN WAYNE CANCER INSTITUTE, THAT SERVE AS CATALYSTS FOR EXCEPTIONAL HEALTH CARE AND RESEARCH. 92 91 0 150 0 0 6622052 17298214 0 0 3518073 2270422 9673 0 10149798 19568636 6225874 9385191 0 0 2424473 3089206 0 0 1542000 1710529 1795823 10360876 14270220 -211078 5298416 123780137 177835052 10272997 63828600 113507140 114006452 TO PROVIDE LEADERSHIP AND PHILANTHROPIC SUPPORT TO PROVIDENCE SAINT JOHN'S HEALTH CENTER AND JOHN WAYNE CANCER INSTITUTE, THAT SERVE AS CATALYSTS FOR EXCEPTIONAL HEALTH CARE AND RESEARCH. 0 0 4305909 4305909 PARTIAL FUNDING FOR THE CONSTRUCTION AND CAPITAL EQUIPMENT NEEDS FOR THE NEW STATE OF THE ART PROVIDENCE SAINT JOHN'S HEALTH CENTER FACILITY. 2685520 2685520 SUPPORT THE ONGOING RESEARCH STUDIES AND TREATMENT MODALITIES AT JOHN WAYNE CANCER INSTITUTE. 2393762 2393762 TO SUPPORT VARIOUS PROGRAMS AND SERVICES BENEFITTING THE HEART, ORTHO, NURSING AND OTHER VARIOUS DEPARTMENTS OF THE PROVIDENCE SAINT JOHN'S HEALTH CENTER. 9385191 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 X 92 91 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X STELLA NICHOLS 3108298424 1919 SANTA MONICA BLVD SANTA MONICA CA 90404 X CHARLES F ADAMS TRUSTEE 1.00 X 0 0 0 DANIEL A ALONI TRUSTEE 1.00 X 0 0 0 MARGOT S ARMBRUSTER TRUSTEE 1.00 X 0 0 0 DONNALISA P BARNUM TRUSTEE 1.00 X 0 0 0 FRANK E BAXTER TRUSTEE 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SHANNON M WICKSTROM TRUSTEE 1.00 X 0 0 0 GRETCHEN A WILLISON TRUSTEE 1.00 X 0 0 0 BRETT G WYARD TRUSTEE 1.00 X 0 0 0 RAE W ARCHIBALD PHD EXECUTIVE COMMITTEE 1.00 X 0 0 0 CRAIG C BENELL EXECUTIVE COMMITTEE 1.00 X 0 0 0 JAMES P BIRDWELL JR EXECUTIVE COMMITTEE 1.00 X 0 0 0 MAUREEN F CRAIG SCL EXECUTIVE COMMITTEE 1.00 X 0 0 0 A R DOMS JR EXECUTIVE COMMITTEE 1.00 X 0 0 0 JERRY B EPSTEIN EXECUTIVE COMMITTEE 1.00 X 0 0 0 MARC EZRALOW EXECUTIVE COMMITTEE 1.00 X 0 0 0 MARY H FLAHERTY EXECUTIVE COMMITTEE 1.00 X 0 0 0 WILLIAM M GARLAND III EXECUTIVE COMMITTEE 1.00 X 0 0 0 MARK W GIBELLO EXECUTIVE COMMITTEE 1.00 X 0 0 0 ALLAN B GOLDMAN EXECUTIVE COMMITTEE 1.00 X 0 0 0 TONIAN HOHBERG EXECUTIVE COMMITTEE 1.00 X 0 0 0 CARL W MCKINZIE ESQ EXECUTIVE COMMITTEE 1.00 X 0 0 0 SHELBY NOTKIN EXECUTIVE COMMITTEE 1.00 X 0 0 0 WILLIAM P RUTLEDGE EXECUTIVE COMMITTEE 1.00 X 0 0 0 CAROLE B SCHWARTZ EXECUTIVE COMMITTEE 1.00 X 0 0 0 DONNA L SCHWEERS EXECUTIVE COMMITTEE 1.00 X 0 0 0 DONNA F TUTTLE EXECUTIVE COMMITTEE 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RESTRICTED 24026028 101986 371966 876096 23623884 23053139 111446 1806045 944602 24026028 21696931 90527 2205046 939365 23053139 22270167 181487 14905 769628 21696931 20431739 917103 2079752 1158427 22270167 0.20340 0.61930 0.17730 0 0 5312161 5312161 1160413 1160413 67169 43742 23427 6496001 GIFT ANNUITIES RECEIVABLE 3595400 CHARITBALE REMAINDER TRUSTS RECEIVABLE 5355635 OTHER ASSETS 252960 9203995 OBLIGATIONS UNDER CHARITABLE GIFT ANNUITIES 2255217 DUE TO SAINT JOHNS HEALTH CENTER & JOHN WAYNE CANCER INSTITUTE 4246423 6501640 15210143 -1289707 7111 -3509398 -4791994 20002137 154755 -588256 -433501 19568636 14710832 7111 7111 14703721 154755 -588256 -433501 14270220 PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE OF GIFT ANNUITIES RECEIVABLE 211,943. CHANGE IN VALUE OF BENEFICIAL INTEREST IN CHARITABLE REMAINDER TRUSTS 755,158. ALLOWANCE FOR UNCOLLECTIBLE PLEDGES RECEIVABLE -4,476,499. PART XI, LINE 4B - OTHER ADJUSTMENTS: SPECIAL EVENT EXPENSES -588,256. PART XII, LINE 4B - OTHER ADJUSTMENTS: SPECIAL EVENT EXPENSES -588,256. CARITAS GALA 641673 240296 401377 224482 176895 POWER OF PINK 571235 384356 186879 95014 91865 0 1212908 624652 588256 319496 268760 588256 0 1 PROVIDENCE SAINT JOHN'S HEALTH CENTER 2121 SANTA MONICA BLVD SANTA MONICA CA 90404 951684082 501(C)(3) 6699671 SUPPORT VARIOUS PROGRAMS; CAPITAL PUCHASES AND SERVICES JOHN WAYNE CANCER INSTITUTE 2200 SANTA MONICA BLVD SANTA MONICA CA 90404 954291515 501(C)(3) 2685520 SUPPORT FOR ONGOING STUDIES 2 PART I, LINE 2: MONIES TO SAINT JOHN'S HEALTH CENTER ARE GRANTED AFTER THE EXPENSES HAVE BEEN INCURRED. THE HEALTH CENTER PROVIDES US WITH AN ITEMIZED BILL, SUPPORTED BY COPIES OF INVOICES PAID RELATED TO EACH GRANT. THE FOUNDATION TRANSFERS THE FUNDS AS SOON AS THEY ARE RECEIVED. FUNDS GIVEN FOR SPECIFIC PROTOCOLS BY QUALIFYING PRIVATE INDUSTRY AND GOVERNMENT ENTITIES ARE THEN ASSIGNED A GRANT "G" NUMBER FOR FINANCIAL TRACKING POST-AWARD BY THE CONTRACTS AND GRANTS OFFICE. PRINCIPAL INVESTIGATORS (PI'S) MAKE REPORTS ON THE FUNDS AS REQUIRED BY THE GRANT MAKER, TYPICALLY ANNUALLY, AND FINANCE PREPARES THE SPENDING REPORT IF REQUIRED. FUNDS RESTRICTED FOR SPECIFIC PI'S THAT ARE NOT FORMALLY ASSOCIATED WITH A SPECIFIC RESEARCH PROTOCOL ARE PLACED INTO THE PI'S DESIGNATED ACCOUNT. X X X X X X 0 0 0 0 0 0 0 0 0 ROBERT O KLEIN PRESIDENT/CEO 457434 0 0 0 0 0 18603 0 1790 0 477827 0 0 0 STELLA NICHOLS CFO 221089 0 0 0 0 0 20498 0 3429 0 245016 0 0 0 ESTHER GALANTI DIRECTOR, DEVELOPMENT 148194 0 0 0 0 0 12566 0 1008 0 161768 0 0 0 IRENE BRISTOL DIRECTOR, DEVELOPMENT 147514 0 0 0 0 0 8726 0 1019 0 157259 0 0 0 X 16 1115555 FMV 0 1 1 PART I, COLUMN (B): NON CASH DONATIONS ARE LISTED BY TOTAL NUMBER OF DONATIONS. PART I, LINE 32B: THE ORGANIZATION ENGAGED AUCTIONEERS TO SELL AUCTION PIECES AT THE SPECIAL EVENTS. FORM 990, PART VI, SECTION A, LINE 4 THE ORGANIZATION AMENDED THEIR BYLAWS AND RESTATED THEIR ARTICLES OF INCORPORATION. THE ORGANIZATION NOW HAS TWO MEMBERS, PROVIDENCE HEALTH SYSTEM- SOUTHERN CALIFORNIA AND SAIN JOHN'S HEALTH CENTER FOUNDATION GOVERNANCE, INC. THE "MEMBERS" MUST APPROVE ALL BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS MEMBERS 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 11 AN ELECTRONIC COPY OF THE 990 AND ITS SUPPORTING SCHEDULES WERE DISTRIBUTED TO THE SAINT JOHN'S HOSPITAL AND HEALTH CENTER FOUNDATION (FOUNDATION) MANAGEMENT TEAM AND GOVERNING BODY FOR THEIR REVIEW PRIOR TO FILING. THE FOUNDATION FORM 990 IS PREPARED AND REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST PROCESS IS MANAGED AND MONITORED BY PROVIDENCE ENTERPRISE RISK MANAGEMENT SERVICES - INTEGRITY & 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: COMPENSATION COMMITTEE; INDEPENDENT COMPENSATION CONSULTANTS; COMPENSATION SURVEYS AND STUDIES; APPROVAL BY THE EXECUTIVE COMMITTEE. 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. SECTION A, LINE 1A W-2'S ARE ISSUED BY PROVIDENCE SAINT JOHN'S HEALTH CENTER, EIN:95-1684082 , AN EXEMPT ORGANIZATION. THE FOUNDATION REIMBURSES THE SALARIES AND WAGES INCLUDING OTHER OPERATING EXPENSES TO THE HEALTH CENTER. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF GIFT ANNUITIES RECEIVABLE 211,943. CHANGE IN VALUE OF BENEFICIAL INTEREST 755,158. ALLOWANCE FOR UNCOLLECTIBLE PLEDGES RECEIVABLE -4,476,499. SAINT JOHN'S HEALTH CENTER FOUNDATION GOVERNANCE INC 2121 SANTA MONICA BLVD SANTA MONICA CA 90404 473249939 CORPORATE MEMBER CA 501(C)(4) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0