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VERITY HEALTH SYSTEM OF CALIFORNIA INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
VERITY HEALTH SYSTEM OF CALIFORNIA INC (EIN 91-2145484)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-05-13
IRS object ID
201101339349303515
Schema version
2009v1.7
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-05-13T13:05:23-04:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1GRANT THORNTON LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1ONE CALIFORNIA STREET SUITE 2300AddressLine1
CitySAN FRANCISCOCity
StateCAState
ZIP Code94111ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN912145484EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1DAUGHTERS OF CHARITY HEALTH SYSTEMBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlDAUGNameControl
Phone6509174501Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line126000 ALTAMONT ROADAddressLine1
CityLOS ALTOS HILLSCity
StateCAState
ZIP Code940224317ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMICHAEL STUARTName
TitleCFO AND VP SYSTEM FINANCETitle
Phone6509174501Phone
Date Signed2011-05-11DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone4159863900Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonRobert IssaiNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line126000 ALTAMONT RDAddressLine1
CityLOS ALTOS HILLSCity
StateCAState
ZIP Code94022ZIPCode
FieldValueIRS element (for citing)
Gross Receipts63708343GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501cXOrganization501c
Web SiteWWW.DOCHS.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2001YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionSEE ATTACHMENT 2ActivityOrMissionDescription
Nbr Voting Members Governing Body8NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees70TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI85939TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1620000ContributionsGrantsPriorYear
Contributions Grants Current Year4873739ContributionsGrantsCurrentYear
Program Service Revenue Prior Year49662033ProgramServiceRevenuePriorYear
Program Service Revenue CY54247369ProgramServiceRevenueCY
Investment Income Prior Year647964InvestmentIncomePriorYear
Investment Income Current Year3481328InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year1105907OtherRevenueCurrentYear
Total Revenue Prior Year51929997TotalRevenuePriorYear
Total Revenue Current Year63708343TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year75300GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY17500GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year15475506SalariesEtcPriorYear
Salaries Etc Current Year16615728SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year39174121OtherExpensePriorYear
Other Expenses Current Year73626321OtherExpensesCurrentYear
Total Expenses Prior Year54724927TotalExpensesPriorYear
Total Expenses Current Year90259549TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-2794930RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-26551206RevenuesLessExpensesCY
Total Assets BOY579202805TotalAssetsBOY
Total Assets EOY580175167TotalAssetsEOY
Total Liabilities BOY634391023TotalLiabilitiesBOY
Total Liabilities EOY661248589TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-55188218NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-81073422NetAssetsOrFundBalancesEOY
Mission DescriptionSEE ATTACHMENT 2MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense67930443Expense
Grants17500Grants
Revenue54161430Revenue
DescriptionTHE DAUGHTERS OF CHARITY HEALTH SYSTEM (SYSTEM) IS A REGIONAL HEALTH SYSTEM IN CALIFORNIA. THE SYSTEM PROVIDES ACUTE, LONG-TERM, COMMUNITY HEALTH, PSYCHIATRIC, REHABILITATION, AND RESIDENTIAL CARE THROUGH HOSPITALS (LOCAL HEALTH MINISTRIES) LOCATED IN NORTHERN AND SOUTHERN CALIFORNIA. THROUGH ITS ACCOUNTING, FINANCE, AND PATIENT FINANCIAL SERVICES DEPARTMENTS, THE ORGANIZATION PROVIDES LEADERSHIP FOR THE SYSTEM AND SUPPORT FOR THE LOCAL HEALTH MINISTRIES. THIS SUPPORT INCLUDES PROVIDING STRATEGIC AND FINANCIAL PLANNING FOR THE LOCAL HEALTH MINISTRIES, INFORMATION REPORTING, NEGOTIATING AND MANAGING CERTAIN SYSTEM-WIDE-CONTRACTS WITH VENDORS TO REDUCE COSTS, INSURANCE VERIFICATION, AND CUSTOMER SERVICE FOR PATIENTS WITH BILLING QUESTIONS.Description
Total Program Service Expense67930443TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Balance Sheet Amounts ReportedtrueBalanceSheetAmountsReported
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPtrueLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109647NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees70NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccounttrueForeignFinancialAccount
Name Of Foreign CountryCJNameOfForeignCountry
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Nbr Voting Governing Body Members8NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChapterstrueLocalChapters
Policies Reference ChapterstruePoliciesReferenceChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProceduretrueWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledCAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMIKE STUARTNamePerson
Telephone Number6509174500TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line126000 ALTAMONT ROADAddressLine1
CityLOS ALTOS HILLSCity
StateCAState
ZIP Code940224317ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (18 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
SISTER JANET BARRETT DC
TREASURER/SECRETARY1.0XX000
SISTER CHRISTINA MAGGI DC
BOARD MEMBER1.0X000
WILLIAM DEL BAGGIO
BOARD MEMBER1.0X000
DANIEL S HIGGINS MD
BOARD MEMBER1.0X000
SISTER MARJORY BAEZ DC
CHAIRPERSON1.0XX000
SISTER MARION BILL DC
VICE CHAIRPERSON1.0XX000
SISTER BETTY MARIE DUNKEL DC
BOARD MEMBER1.0X000
SISTER JUDITH LYNN GARDENHIRE
BOARD MEMBER1.0X000
ROBERT ISSAI
PRESIDENT & CEO40.0X10994830283013
MICHAEL STUART
CFO AND VP, SYSTEM FINANCE40.0X401415075172
HAYDEN KLAEVEMAN
VP, QUALITY40.04779540104117X
CONWAY COLLIS
VP, ADVOCACY40.0418414086691X
RICHARD D HUTSELL
VP OF IT AND CIO40.03479550132671X
GERALD T KOZAI
PRESIDENT AND CEO, SFMC40.05573920160288X
MARGARET CATHERINE FICKES
PRESIDENT AND CEO, SVMC40.04943490132489X
JOANNE EVELYN ALLEN
PRESIDENT AND CEO, SLRH40.0375024078578X
JAMES DOVER
PRESIDENT AND CEO, SLRH40.039114505814X
Lorraine Auerbach
PRESIDENT AND CEO, SMC40.0519078031767X
FieldValueIRS element (for citing)
Total Reportable Comp From Org5082209TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation1090600TotalOtherCompensation
Number Individuals GT100 K49NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
ROPES AND GRAY LLP
ONE INTERNATIONAL PLACEBOSTONMA02110LEGAL & CONSULTING2716481
DELOITTE AND TOUCHE LLP
111 BROADWAY SUITE 2100OAKLANDCA94607AUDITING SERVICES1112143
Freed and Associates
412 Yale AvenueKENSINGTONCA94708Consulting334315
DICKSTEIN SHAPIRO
1825 I STREET NWWASHINGTONDC20006LEGAL679069
LITTLER MENDELSON
PO BOX 45547SAN FRANCISCOCA94145LEGAL325833
FieldValueIRS element (for citing)
Number Of Contractors GT100 K13NumberOfContractorsGT100K
Related Organizations2698113RelatedOrganizations
All Other Contributions2175626AllOtherContributions
Total Contributions4873739TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
REGIONAL LEADERSHIP AND ADMINISTRATION9000995225832152258321
PTNRSP INCOME- PROGRAM SERVICES5419001960248187430985939
OTHER OPERATING9000992880028800
FieldValueIRS element (for citing)
Total Program Service Revenue54247369TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column3481328TotalRevenueColumn
Exclusion$3,481,328ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionINSURANCE EXPENSE REVERSALDescription
Business Code900099BusinessCode
Total Revenue Column1105907TotalRevenueColumn
Exclusion$1,105,907ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue1105907TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column63708343TotalRevenueColumn
Related Or Exempt Function Income54161430RelatedOrExemptFunctionIncome
Unrelated Business Revenue85939UnrelatedBusinessRevenue
Exclusion$4,587,235ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total17500Total
Program Services17500ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total2711343Total
Program Services2033507ProgramServices
Management And General677836ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total9383028Total
Program Services7037271ProgramServices
Management And General2345757ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2294625Total
Program Services1720969ProgramServices
Management And General573656ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1659240Total
Program Services1244430ProgramServices
Management And General414810ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total567492Total
Program Services425619ProgramServices
Management And General141873ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total8047451Total
Program Services6035588ProgramServices
Management And General2011863ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total2824989Total
Program Services2118742ProgramServices
Management And General706247ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total2196459Total
Program Services1647344ProgramServices
Management And General549115ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total547788Total
Program Services410841ProgramServices
Management And General136947ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total274939Total
Program Services206204ProgramServices
Management And General68735ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total26183936Total
Program Services19637952ProgramServices
Management And General6545984ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total707843Total
Program Services530882ProgramServices
Management And General176961ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total403433Total
Program Services302575ProgramServices
Management And General100858ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total319967Total
Program Services239975ProgramServices
Management And General79992ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total295487Total
Program Services221615ProgramServices
Management And General73872ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total400273Total
Program Services300205ProgramServices
Management And General100068ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total0Total

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
PURCHASED SERVICES16167511212563404188
ALL OTHER28874521655972186
REVERSE OF PY CONTRIBUTIONS925626925626
SYSTEM ACTUARIAL PENSION28592634214444767148158

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total90259549Total
Program Services67930443ProgramServices
Management And General22329106ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY55714000BOY
EOY62762000EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY7400000BOY
EOY0EOY
FieldValueIRS element (for citing)
Accounts ReceivableAccountsReceivable

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY548515BOY
EOY1001510EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY4371561BOY
EOY6142635EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis817165LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec766523LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY165819BOY
EOY50642EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY4068657BOY
EOY1874382EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY506934253BOY
EOY508343997EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY579202805BOY
EOY580175167EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY5386397BOY
EOY10630666EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY472373000BOY
EOY462515000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY156631626BOY
EOY188102923EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY634391023BOY
EOY661248589EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-56914937BOY
EOY-83125015EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1726719BOY
EOY2051593EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-55188218BOY
EOY-81073422EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY579202805BOY
EOY580175167EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type2XSupportingOrg509a3Type2
Certification CheckboxXCertificationCheckbox
Contrib By Controlling IndividualfalseContribByControllingIndividual
Contribution By Related PartyfalseContributionByRelatedParty
Contrib By35 Controlled EntityfalseContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation (6 entries)

EINEINType Of OrganizationTypeOfOrganizationListed In Governing DocListedInGoverningDocAmountAmount
ROBERT F KENNEDY MEDICAL CENTER
91215444003true$0
O'CONNOR HOSPITAL
91215443603true$0
SAINT LOUISE REGIONAL HOSPITAL
91215443703true$0
SETON MEDICAL CENTER
91215444103true$0
ST FRANCIS MEDICAL CENTER
91215443903true$0
ST VINCENT MEDICAL CENTER
91215443803true$0
FieldValueIRS element (for citing)
Total Number Of Supported Orgs6TotalNumberOfSupportedOrgs

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementtruePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationstrueGrantsOtherOrganizations
Grants Other Organizations$186,025GrantsOtherOrganizationsAmount
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$361,763OtherActivitiesAmount
Total Lobbying Expenditures IIB547788TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierSchedule C, Part II-B, Line 1iIdentifier
ExplanationThe majority of the lobbying expenditures for FY 2010 regarded the state passage (and federal approval) of a hospital provider fee program that yielded approximately $50 million to the Daughters of Charity Health System in FY 2011 on the basis of DCHS' service to Medi-Cal patients. A smaller portion of the expenditures were spent on other legislative matters.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
LandLand

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis33700OtherCostOrOtherBasis
Depreciation33700Depreciation

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis579495OtherCostOrOtherBasis
Depreciation562485Depreciation
Book Value17010BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis203970OtherCostOrOtherBasis
Depreciation170338Depreciation
Book Value33632BookValue
FieldValueIRS element (for citing)
Other Land BuildingsOtherLandBuildings
Total Of Book Value Land Buildings50642TotalOfBookValueLandBuildings

Other Assets OtherAssets (8 entries)

DescriptionDescriptionBook ValueBookValue
DUE FROM RELATED PARTIES459357093
UNDER BOND INDENTURE AGREEMENT43768504
2005 DEF COST OF ISSUANCE898803
2005 DEF UNDERWRITER FEE1708156
SECURITY DEPOSIT16426
OTHER CURRENT ASSETS780393
2008A DEF COST OF ISSUANCE879967
2008A DEF UNDERWRITER FEE934655
FieldValueIRS element (for citing)
Total Book Value Other Assets508343997TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
WORKERS COMPENSATION$115,863
DUE TO GOVERNMENT AGENCIES$1,841
PENSION OBLIGATION$163,944,219
OTHER ACCRUED LIABILITIES$24,041,000
FieldValueIRS element (for citing)
Total Of Amounts188102923TotalOfAmounts

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained
No Grant More Than5000XNoGrantMoreThan5000

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierGRANTS PAID BY THE DAUGHTERS OF CHARITY HEALTH SYSTEMIdentifier
Return ReferenceSCHEDULE I, PARTS I & IIReturnReference
ExplanationDCHS MAKES GRANTS TO ACTIVITIES THAT PROMOTE HEALTH IMPROVEMENT INITIAYIVES AND THAT IMPROVE THE LOCAL COMMUNITY'S WELL-BEING. DCHS REVIEWS THE GRANT REQUEST IN DETAIL AND A GRANT IS ONLY MADE ONCE THE DCHS BOARD DETERMINES THAT THE RECIPIENT OF THE GRANT WILL USE THE FUNDS TO FURTHER DCHS'S MISSION AND TO PROMOTE POSITIVE PUBLIC AWARENESS. AFTER THE FUNDS ARE GRANTED DCHS MONITORS THE GRANT TO ENSURE IT IS USED APPROPRIATELY.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Discretionary Spending AccountXDiscretionarySpendingAccount
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
ROBERT ISSAI
874038000225445026276302025001382496000
MICHAEL STUART
387499000139160517750233970476587000
HAYDEN KLAEVEMAN
37826200099692010312509920582071000
CONWAY COLLIS
39681300021601078050086410505105000
RICHARD D HUTSELL
3267980002115701018610308100480626000
GERALD T KOZAI
5391870001820501319180283700717680000
MARGARET CATHERINE FICKES
4319090006244001054720270170626838000
JOANNE EVELYN ALLEN
359909000151150414800370980453602000
JAMES DOVER
28187800010926700058140396959000
Lorraine Auerbach
42104100098037000317670550845000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
BENEFITS PROVIDED BY DCHSDiscretionary spending account: The President and CEO of DCHS is provided a discretionary spending account with an annual limit of $25,000 as part of his employment contract. The payments are reported as taxable compensation and reported on Form W-2. All the compensated individuals listed in Part VII receive an auto allowance. The payments are reported as taxable compensation and reported on Form W-2. Health or social club dues: The VP of Advocacy receives reimbursements for Social Club Dues. The payments are reported as taxable compensation and reported on Form W-2.
NONQUALIFIED RETIREMENT PLANThe following individuals participated in supplemental nonqualified retirement plans, which are included in compensation reported on Schedule J, Part II, Column C: Conway Collis $32,500 Robert Issai $87,550 Gerald Kozai $53,805 Michael Stuart $39,269 Margaret Fickes $25,190 The following individual received payments from supplemental nonqualified retirement plans that are included in compensation reported on Schedule J, Part II, Column B(iii): Margaret Fickes $38,227SCHEDULE J, PART I, LINE 4B

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuer
CA STATEWIDE COMMUNITIES DEV AUTHY
680164610130911A832005-03-18507644195EQUIPMENT ACQ. & REFUND 2001 BONDSfalsefalse
CA STATEWIDE COMMUNITIES DEV AUTHY
680164610130795ZS92008-11-18143655000REFUND 2005 SERIES B BONDSfalsefalse

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Total ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundAmount DefeasedAmountDefeasedIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
653846082805506320000005329545300000002005falsetruetruetrue
13716799137131533646truefalsetruetrue

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Counsel Routinely EngagedBondCounselRoutinelyEngagedPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUsePost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
falsefalsefalsefalsetrue0.010600.000000.01060true
falsefalsefalsefalsetrue0.000000.000000.00000true

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
falsetruefalsefalsefalsetrue
falsefalsefalsefalsefalsetrue

Schedule L IRS990ScheduleL

Loan Table LoanTable (3 entries)

Purpose Of LoanPurposeOfLoanLoan From OrganizationLoanFromOrganizationOriginal PrincipalOriginalPrincipalAmountBalance DueBalanceDueDefaultDefaultApproved By BoardApprovedByBoardWritten AgreementWrittenAgreement
Robert Issai
HOME PURCHASEX$912,000365677falsetruetrue
Lorraine Auerbach
HOME PURCHASEX$500,000427500falsetruetrue
James Dover
HOME PURCHASEX$250,000208333falsetruetrue
FieldValueIRS element (for citing)
Total Balance Due1001510TotalBalanceDue

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (2 entries)

IdentifierIdentifierExplanationExplanation
Form 990 Part IV, Line 12, and Part XI, Line 2b and 2cThe financial statements of the organization are consolidated by the Daughters of Charity Health System and include each of the affiliated Local Health Ministries, their related fundraising Foundations and other related organizations (as listed on form 990 Schedule R) in accordance with GAAP and audited by an independent public accounting firm. The Daughters of Charity Health System's Board and Audit Committee of the Board has responsibility for oversight of the audit of the consolidated financial statements and selection of the independent public accounting firm. Form 990 Part VI, Line 6 The Daughters of Charity Health System has only one member, the Daughters of Charity Ministry Services Corporation, a California nonprofit religious corporation. Form 990 Part VI, Line 7a The Member's Board of Directors may appoint the organization's directors and officers. Form 990 Part VI, Line 7b The sole member has broad powers including the power to amend the Bylaws and Articles of Incorporation, and approve, interpret and change any statement of mission, philosophy, role or purpose of Daughters of Charity Health System. The member has the right to approve any merger, dissolution, consolidation or reorganization of Daughters of Charity Health System. In addition, the member has the right to approve capital and operating budgets, approve debt incurred or guaranteed, approve the disposition of the assets, and establish policy concerning quality of care, finance and resources. Finally, the member has such other powers and rights as provided by the California Nonprofit Corporation Law. Form 990, Part VI, Line 11A Grant Thornton LLP and the System's finance staff work together to gather the required tax information necessary to complete the tax returns. The initial draft return is reviewed by Grant Thornton and the System's finance staff, and the Chief Financial Officer. After the return is discussed and reviewed, recommended changes are reflected on the return and a draft tax return is prepared. The full Board of Directors of the organization receives the final version of the draft return and the return is reviewed with the Board of Directors prior to the return being filed. Form 990, Part VI, Line 12c The Daughters of Charity Health System ("DCHS") has a Conflict of Interest Policy that covers DCHS and all of its affiliates. The policy provides for a systematic and ongoing method of requiring individuals who have decision making responsibility to disclose and address potential and actual conflicts of interest. Covered individuals are required to complete an annual statement disclosing any conflicts of interest and have a duty to update the disclosure for any potential conflicts of interest that arise during the year. The Presidents/CEOs of the Local Health Ministries report the conflict of interest findings and resolutions to their respective Board of Directors. This policy is reviewed annually for compliance by the DCHS's Corporate Responsibility Officer. Form 990, Part VI, Line 15a and 15b The Daughters of Charity Health System ("DCHS") compensation programs cover DCHS and all of its affiliated Local Health Ministries. The CEO of each Local Health Ministry is employed by DCHS. The DCHS compensation programs are designed to recruit, retain, and motivate qualified executives. The programs are designed for positions that have a significant impact on the high-level strategic and policy direction of the Daughters of Charity Health System and its affiliated Local Health Ministries. All of the Local Health Ministry CEOs are paid directly by the Daughters of Charity Health System and covered by the Daughters of Charity Health System compensation programs. Market data analyses are made of comparable organizations within the industry and within the region. Total compensation is established for all executive positions to target similar total compensation of comparable organization market compensation. Base pay is established for all executive positions to target the median range of comparable organization market compensation. The Daughters of Charity Health System utilizes a benefits committee to review compensation and benefits. The Daughters of Charity Health System Board of Directors reviews and approves compensation recommended by the benefits committee, and documents its conclusion that the proposed compensation is reasonable. In evaluating and finalizing its determination of base pay and total compensation for comparable positions at comparable organizations in comparable markets, DCHS utilizes available market data analyses including the DCHS benefits committee, independent compensation consultant, Form 990 of other organizations, written employment contracts, compensation survey or study, recommendation of the benefits committee and approval by the DCHS Board of Directors. Form 990, Part VI, Line 19 The Daughters of Charity Health System makes its Form 990 available upon request. Schedule A, Part I, Line 11h Robert F. Kennedy Medical Center, O' Connor Hospital, Saint Louise Regional Hospital, Seton Medical Center, St. Francis Medical Center and St. Vincent Medical Center are affiliated corporations with Daughters of Charity Health System ("DCHS"), as defined in its bylaws. Each local health ministry is controlled by DCHS by operation of DCHS being the sole member corporation of each supported organization and being named as such in the bylaws of each listed supported organization. See Attachment 2 for a description of support provided to each of the affiliated corporations. Schedule K, Part I The tax exempt bond liabilities were issued for the purpose of borrowing funds to (1) acquire property, plant, and equipment of certain acute health care hospitals owned by Daughters of Charity Health System or its affiliates, (2) fund certain routine capital expenditures of the members, and (3) pay the cost of insuring the bonds.
Schedule R, Part IIThe following organizations listed below are related to the filing organization including the organization itself: Daughters of Charity Ministry Services Corporation 3663 Martin Luther King Jr. Blvd. Lynwood, CA 90262 EIN: 77-0482943 Col (B): Primary Activity - Managerial and consulting services in the areas of finance, administration and facilities to the Daughters of Charity of St. Vincent de Paul Province of the West ministries. Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501 (c)(3) Col (E): Public Charity Status - 1 Col (F): Direct Controlling Entity Name - Daughters of Charity of St. Vincent de Paul Province of the West Daughters of Charity Health System 26000 Altamont Road Los Altos Hills, CA 94022-4317 EIN: 91-2145484 Col (B): Primary Activity - Health System leadership and support to health ministries. Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501(c)(3) Col (E): Public Charity Status - 11b Col (F): Direct Controlling Entity Name - Daughters of Charity Ministry Services Corporation Caritas Business Services 203 Redwood Shores Parkway, Suite 800 Redwood City, CA 94065 EIN: 51-0659139 Col (B): Primary Activity - Promote and support the activities of the Daughters of Charity Health System and its local health ministries by performing accounting, budgeting and patient financial services on a centralized basis, all of which must be provided internally by each hospital for its exempt operations if not provided by Caritas Business Services. Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501(c)(3) Col (E): Public Charity Status - 11a Col (F): Director Controlling Entity Name - Daughters of Charity Health System Hotel Dieu, Inc. 3663 Martin Luther King Blvd. Lynwood, California 90262 EIN: 95-475156 Col (B): Primary Activity - Low-Income residence for fragile senior citizens Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501(c)(3) Col (E): Public Charity Status - 9 Col (F): Director Controlling Entity Name - Daughters of Charity Ministry Services Corporation O'Connor Hospital 2105 Forest Avenue San Jose, CA 95128 EIN: 91-2154436 Col (B): Primary Activity - Hospital Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501(c)(3) Col (E): Public Charity Status - 3 Col (F): Direct Controlling Entity Name - Daughters of Charity Health System O'Connor Hospital Foundation 2105 Forest Avenue San Jose, CA 95128 EIN: 77-0006295 Col (B): Primary Activity - Fundraising Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501(c)(3) Col (E): Public Charity Status - 11a Col (F): Direct Controlling Entity Name - O'Connor Hospital Robert F. Kennedy Medical Center 26000 Altamont Road Los Altos Hills, CA 94022 EIN: 91-2154440 Col (B): Primary Activity - Hospital - Inactive Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501(c)(3) Col (E): Public Charity Status - 3 Col (F): Direct Controlling Entity Name - Daughters of Charity Health System Robert F. Kennedy Medical Center Foundation 26000 Altamont Road Los Altos Hills, CA 94022 EIN: 95-3745227 Line (B): Primary Activity - Fundraising Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501(c)(3) Col (E): Public Charity Status - 11a Col (F): Direct Controlling Entity Name - Robert F. Kennedy Medical Center St. Francis Medical Center 3630 East Imperial Highway Lynwood, CA 90262 EIN: 91-2154439 Col (B): Primary Activity - Hospital Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501(c)(3) Col (E): Public Charity Status - 3 Col (F): Direct Controlling Entity Name - Daughters of Charity Health System St. Francis Medical Center of Lynwood Foundation 3630 East Imperial Highway Lynwood, CA 90262-2636 EIN: 95-3190773 Col (B): Primary Activity - Fundraising Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501(c)(3) Col (E): Public Charity Status - 11a Col (F): Direct Controlling Entity Name - St. Francis Medical Center Saint Louise Regional Hospital 9400 No Name Uno Gilroy, CA 95020 EIN: 91-2154437 Col (B): Primary Activity - Hospital Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501(c)(3) Col (E): Public Charity Status - 3 Col (F): Direct Controlling Entity Name - Daughters of Charity Health System Saint Louise Regional Hospital Foundation 18550 De Paul Drive Morgan Hill, CA 95037 EIN: 56-2384735 Col (B): Primary Activity - Fundraising Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501(c)(3) Col (E): Public Charity Status - 11a Col (F): Direct Controlling Entity Name - Saint Louise Regional Hospital St. Vincent Medical Center 2131 West 3rd Street Los Angeles, CA 90057 EIN: 91-2154438 Col (B): Primary Activity - Hospital Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501(c)(3) Col (E): Public Charity Status - 3 Col (F): Direct Controlling Entity Name - Daughters of Charity Health System St. Vincent de Paul Ethics Corporation 3630 East Imperial Hwy Lynwood, Ca 90262 EIN: 95-4426405 Col (B): Primary Activity - Supports DCHS Ministries Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501 (c)(3) Col (E): Public Charity Status - 11a Col (F): Direct Controlling Entity Name - St. Francis Medical Center St. Vincent Dialysis Center 2131 West 3rd Street Los Angeles, CA 90057 EIN: 95-3749293 Col (B): Primary Activity - Hospital Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501(c)(3) Col (E): Public Charity Status - 3 Col (F): Direct Controlling Entity Name - St. Vincent Medical Center St. Vincent Foundation 2131 West 3rd Street Los Angeles, CA 90057 EIN: 95-3922511 Col (B): Primary Activity - Fundraising Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501(c)(3) Col (E): Public Charity Status - 11a Col (F): Direct Controlling Entity Name - St. Vincent Medical Center St. Vincent Senior Center Nutrition Program, Inc. 2131 West 3rd Street Los Angeles, Ca 90057-1901 EIN: 95-3696693 Col (B): Primary Activity - Nutrition Program Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501(c)(3) Col (E): Public Charity Status - 9 Col (F): Direct Controlling Entity Name - Daughters of Charity Ministry Services Corporation Seton Medical Center 1900 Sullivan Avenue Daly City, CA 94015 EIN: 91-2154441 Col (B): Primary Activity - Hospital Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501(c)(3) Col (E): Public Charity Status - 3 Col (F): Direct Controlling Entity Name - Daughters of Charity Health System Seton Medical Center Foundation 1900 Sullivan Avenue Daly City, CA 94015 EIN: 94-2824033 Col (B): Primary Activity - Fundraising Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501(c)(3) Col (E): Public Charity Status - 11a Col (F): Direct Controlling Entity Name - Seton Medical Center Schedule R, Part III O'Connor Health Center, A California Limited Partnership 1960 The Alameda, Suite 20 San Jose, CA 95126 EIN: 77-0419045 Col (B): Primary Activity - Development and Rental Col (C): Legal Domicile - CA Col (D): Direct Controlling Entity Name - O'Connor Hospital Col (E): Predominant Income - Investment or other income excluded from tax under section 512, 513, or 514 Col (F): Share of Total Income - $567,829 Col (G): Share of end-of-year assets - $5,204,246 Col (H): Disproportionate Allocations - No Col (I): Code V - UBI Amount in Box 20 of Schedule K-1 (Form 1065) - N/A Col (J): General or Managing Partner - No Campbell-Gateway Square, A California Limited Partnership 1960 The Alameda, Suite 20 San Jose, CA 95126 EIN 77-0313494 Col (B): Primary Activity - Development and Rental Col (C): Legal Domicile - CA Col (D): Direct Controlling Entity Name - O'Connor Hospital Col (E): Predominant Income - Unrelated Business Income Col (F): Share of Total Income - $660,888 Col (G): Share of end-of-year assets - $3,707,310 Col (H): Disproportionate Allocations - No Col (I): Code V - UBI Amount in Box 20 of Schedule K-1 (Form 1065) -N/A Col (J): General or Managing Partner - No Schedule R, Part IV Marillac Insurance Company, Ltd. c/o Aon Insurance Managers (Cayman), Ltd. P.O. Box 69GT, B.W.I., Cayman Islands EIN: 98-0417930 Col (B): Primary Activity - Insurance Col (C): Legal Domicile - CJ Col (D): Direct Controlling Entity Name - Daughters of Charity Health System Col (E): Type of Entity - C Corporation Col (F): Share of Total Income - $7,575,033 Col (G): Share of end-of-year assets - $66,507,221 Col (H): Percentage ownership - 100%

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1SEE SCHEDULE OBusinessNameLine1

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1SEE SCHEDULE OBusinessNameLine1

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1SEE SCHEDULE OBusinessNameLine1
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (14 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
OCONNOR HOSPITAL
N101194
OCONNOR HOSPITAL
P216313
OCONNOR HOSPITAL
P20958329
MARILLAC INSURANCE COMPANY
B15821864
MARILLAC INSURANCE COMPANY
R6000000
ROBERT F KENNEDY MEDICAL CENTER
C2698113
SAINT LOUISE REGIONAL HOSPITAL
P237201
SAINT LOUISE REGIONAL HOSPITAL
P7832813
SETON MEDICAL CENTER
N89929
SETON MEDICAL CENTER
P260867
SETON MEDICAL CENTER
P18903052
ST FRANCIS MEDICAL CENTER
P34643674
ST FRANCIS MEDICAL CENTER
O588472
ST VINCENT MEDICAL CENTER
P19226223